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NPI Code Detail

MEDICARE: JIBRAN FATEH MD

MEDICARE: JIBRAN FATEH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician4301510886MI

General Provider Information

NPI Number : 1083281786
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIBRAN FATEH MD
Provider Business Mailing Address
First Line : 1500 E MEDICAL CENTER DR
Second Line :
City : ANN ARBOR
State : MI
Zip : 48109-5000
Country : US
Telephone Number : 734-489-3148
Fax Number : 734-489-3148
Provider Business Practice Location Address
First Line : 1500 E MEDICAL CENTER DR
Second Line :
City : ANN ARBOR
State : MI
Zip : 48109-5000
Country : US
Telephone Number : 734-489-3148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2021
Last Update Date : 06/08/2026

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