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General NPI Number Information
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NPI Number | 1134328180
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Entity Type | Organization
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Legal Business Name | ALAN T GHASSAN MD PC
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 02/21/2012
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Provider Practice Location Address
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Address Line | 24333 ORCHARD LAKE RD SUITE C
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-1976
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Country | US
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Telephone | 248-477-9800
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Fax | 248-477-9801
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Provider Business Mailing Address
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Address Line | 24333 ORCHARD LAKE RD SUITE C
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-1976
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Country | US
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Telephone | 248-477-9800
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Fax | 248-477-9801
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALAN T GHASSAN
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Credential | MD
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Telephone | 248-477-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | AG081430
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License Number State | MI
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