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General NPI Number Information
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NPI Number | 1356363311
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Entity Type | Individual
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Provider Name | EIAD KSEIBI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 7633 E JEFFERSON AVE SUITE 360
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City | DETROIT
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State | MI
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Zip | 48214-3730
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Country | US
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Telephone | 313-499-4985
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Fax | 313-499-4955
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Provider Business Mailing Address
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Address Line | 4973 CARLSON PARK DR
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City | TROY
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State | MI
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Zip | 48098-4647
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Country | US
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Telephone | 248-722-8029
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 4301077122
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 4301077122
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 4301077122
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License Number State | MI
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