Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086X0206X | Surgical Oncologist | 36.082163 | OH |
Y | 2086X0206X | Surgical Oncologist | 4210198273 | MI |
NPI | 1417510116 |
---|---|
Provider Name | Dr. Yasser All Haji |
First Address | Madison Heights, MI 48071-3472 |
Second Address | Warren, MI 48093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2019 |
Last Update Date | 10/06/2019 |