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General NPI Number Information
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NPI Number | 1245503788
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Entity Type | Individual
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Provider Name | EMAD KISHI MD
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Gender | Male
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 06/06/2022
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Provider Practice Location Address
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Address Line | 22101 MOROSS RD STE 480
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City | DETROIT
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State | MI
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Zip | 48236-2148
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Country | US
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Telephone | 313-343-3048
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Fax | 313-343-7349
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Provider Business Mailing Address
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Address Line | 29478 JUNEAU LN
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-2751
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Country | US
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Telephone | 857-265-5600
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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 | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | ME135627
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | AL37466
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301505425
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License Number State | MI
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