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General NPI Number Information
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NPI Number | 1255410940
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Entity Type | Organization
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Legal Business Name | ZOUHEIR FARES
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 12/30/2013
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Provider Practice Location Address
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Address Line | 8384 HOLLY RD SUITE 1
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City | GRAND BLANC
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State | MI
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Zip | 48439-1976
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Country | US
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Telephone | 810-733-8400
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Fax | 810-733-2634
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Provider Business Mailing Address
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Address Line | 8384 HOLLY RD STE 1
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City | GRAND BLANC
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State | MI
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Zip | 48439-1974
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Country | US
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Telephone | 810-733-8400
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Fax | 810-733-2634
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Authorized Official
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Title or Position | OWNER
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Name | DR. ZOUHEIR FARES
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Credential | DO
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Telephone | 810-733-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5101008104
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License Number State | MI
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