Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | DS043124 | MI |
N | 207YS0123X | Facial Plastic Surgeon | 043124 | MI |
NPI | 1073521035 |
---|---|
Provider Name | Dhafer S Younan Salama |
First Address | Warren, MI 48093 |
Second Address | Warren, MI 48093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D83157 | (02) |