Individual
KASSEM SOUFAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2050 N HAGGERTY RD, CANTON, MI 48187-3795
(734) 446-9757
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301511386
MI
Other
Enumeration date
06/09/2021
Last updated
10/30/2024
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