Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MF050148 | MI |
NPI | 1245340983 |
---|---|
Provider Name | Mr. Michael H Fakih |
First Address | Saginaw, MI 48604-9515 |
Second Address | Saginaw, MI 48604-9515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1607301802 | BCBS (01) | MI |
B46726 | (02) | MI |