Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 4301085458 | MI |
NPI | 1407067416 |
---|---|
Provider Name | Fadia Ali Altairy |
First Address | Dearborn, MI 48126-2216 |
Second Address | Detroit, MI 48202-2608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 26/03/2021 |