Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 4301039393 | MI |
NPI | 1003857996 |
---|---|
Provider Name | Dr. Samir F Fuleihan |
First Address | Detroit, MI 48201-2020 |
Second Address | Detroit, MI 48201-2018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 30/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
466999010 | (05) | MI |
A66911 | (02) | MI |