Healthcare Provider Details

I. General information

NPI: 1619761707
Provider Name (Legal Business Name): MR. FEVZI ATASEVEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 04/05/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE FL 3
LANSING MI
48912-1811
US

IV. Provider business mailing address

1514 SHEPARD CIR
ELK GROVE VILLAGE IL
60007-2845
US

V. Phone/Fax

Practice location:
  • Phone: 810-845-9180
  • Fax: 517-364-3994
Mailing address:
  • Phone: 224-322-1358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: