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General NPI Number Information
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NPI Number | 1861037335
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Entity Type | Individual
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Provider Name | SARAH DURIAH NAAMOU PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 6450 MAPLE ST
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City | DEARBORN
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State | MI
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Zip | 48126-2259
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Country | US
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Telephone | 313-216-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 24885 ORCHID ST
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City | HARRISON TOWNSHIP
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State | MI
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Zip | 48045-3365
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Country | US
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Telephone | 248-722-9168
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601009518
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License Number State | MI
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