Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 4301068565 | MI |
NPI | 1003840844 |
---|---|
Provider Name | Said M Issa |
First Address | Ann Arbor, MI 48108-1410 |
Second Address | Ann Arbor, MI 48108-1410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 02/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4277696 | (05) | MI |
H32433 | (02) | MI |