Healthcare Provider Details

I. General information

NPI: 1801085022
Provider Name (Legal Business Name): DETROIT VISITING PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24418 MICHIGAN AVE
DEARBORN MI
48124-1837
US

IV. Provider business mailing address

24418 MICHIGAN AVE
DEARBORN MI
48124-1837
US

V. Phone/Fax

Practice location:
  • Phone: 313-427-8826
  • Fax: 313-427-8821
Mailing address:
  • Phone: 313-427-8826
  • Fax: 313-427-8821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FARES FEHMI YASIN
Title or Position: DOCTOR/OWNER
Credential: MD
Phone: 414-336-5480