Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301069026 | MI |
N | 111NI0900X | Internist | 4301069026 | MI |
N | 207RH0000X | Hematologist | 4301069026 | MI |
Y | 207RX0202X | Medical Oncology | 062977 | GA |
N | 207RX0202X | Medical Oncology | 4301069026 | MI |
NPI | 1437196433 |
---|---|
Provider Name | Bassel Fouad El-Rayes |
First Address | Detroit, MI 48201-2061 |
Second Address | Detroit, MI 48201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 10/07/2018 |