Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301078637 | MI |
N | 111NI0900X | Internist | 4301078637 | MI |
Y | 207RX0202X | Medical Oncology | 4301078637 | MI |
NPI | 1013960384 |
---|---|
Provider Name | Dr. Ammar Sukari |
First Address | Troy, MI 48083-1138 |
Second Address | Detroit, MI 48201-2013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 27/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013960384 | (05) | MI |
11-0950041-2 | BCBS PIN # (01) | MI |
5209663 | (05) | MI |
5214879 | (05) | MI |
5223420 | (05) | MI |
I60059 | (02) | MI |