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General NPI Number Information
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NPI Number | 1063822377
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Entity Type | Individual
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Provider Name | ADAM MOHAMED FAHS
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Gender | Male
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 15855 19 MILE RD
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City | CLINTON TWP
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State | MI
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Zip | 48038-3504
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Country | US
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Telephone | 586-263-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FORD PL STE 3A
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 313-876-9490
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2019009468
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301105375
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License Number State | MI
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