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General NPI Number Information
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NPI Number | 1760988406
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Entity Type | Individual
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Provider Name | SAMAA LUTFI DO
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Gender | Female
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 6001 W OUTER DR STE 121
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City | DETROIT
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State | MI
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Zip | 48235-2626
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Country | US
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Telephone | 313-966-3222
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Fax | 313-966-4901
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Provider Business Mailing Address
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Address Line | 5107 FAIRLANE WOODS DR
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City | DEARBORN
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State | MI
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Zip | 48126-2612
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5101025999
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number | 5101025999
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License Number State | MI
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