Healthcare Provider Details

I. General information

NPI: 1154554590
Provider Name (Legal Business Name): ASSAD SATTAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 12/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 GREENFIELD RD STE 101
DEARBORN MI
48126-6004
US

IV. Provider business mailing address

6050 GREENFIELD RD STE 101
DEARBORN MI
48126-6004
US

V. Phone/Fax

Practice location:
  • Phone: 313-945-9000
  • Fax: 313-945-9000
Mailing address:
  • Phone: 313-945-9000
  • Fax: 313-945-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number4301095016
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: