Healthcare Provider Details

I. General information

NPI: 1740952647
Provider Name (Legal Business Name): FADI TORO MD, MMSC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 FRANK LLOYD WRIGHT DR STE H-2100
ANN ARBOR MI
48105-9484
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR STE H-2100
ANN ARBOR MI
48105-9484
US

V. Phone/Fax

Practice location:
  • Phone: 734-232-4986
  • Fax:
Mailing address:
  • Phone: 216-444-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number4351052085
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: