Healthcare Provider Details

I. General information

NPI: 1992332316
Provider Name (Legal Business Name): MICHAEL FAYAD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 ELLIOTT DR
YPSILANTI MI
48197-8632
US

IV. Provider business mailing address

5300 ELLIOTT DR
YPSILANTI MI
48197-8632
US

V. Phone/Fax

Practice location:
  • Phone: 734-434-6262
  • Fax: 734-712-2820
Mailing address:
  • Phone: 734-434-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number5101029089
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036.161841
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.161841
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: