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General NPI Number Information
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NPI Number | 1912202656
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Entity Type | Individual
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Provider Name | MAHMOUD SAAD TARSIN MD
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Gender | Male
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Dates
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Enumeration Date | 01/11/2011
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 4160 JOHN R ST SUITE 1021
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City | DETROIT
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State | MI
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Zip | 48201-2020
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Country | US
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Telephone | 313-966-9852
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Fax | 313-745-8222
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Provider Business Mailing Address
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Address Line | 4675 DEPARTMENT
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City | CAROL STREAM
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State | IL
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Zip | 60122-0021
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Country | US
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Telephone | 810-720-5715
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Fax | 810-732-0891
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4301086902
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License Number State | MI
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