Healthcare Provider Details

I. General information

NPI: 1780616359
Provider Name (Legal Business Name): AYOUB SAYEG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 GREENFIELD RD
DEARBORN MI
48126-4124
US

IV. Provider business mailing address

4700 GREENFIELD RD
DEARBORN MI
48126-4124
US

V. Phone/Fax

Practice location:
  • Phone: 313-945-6100
  • Fax: 313-945-5260
Mailing address:
  • Phone: 313-945-6100
  • Fax: 313-945-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberAS072477
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: