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NPI Code Detail

MEDICARE: DR. SAMIR SOTOUHI M.D.

MEDICARE: DR. SAMIR SOTOUHI M.D.
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
12084N0400XNeurology Physician4301044804MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21308255022OTHERMIBLUE CROSS BLUE SHEILD

General Provider Information

NPI Number : 1659305605
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMIR SOTOUHI M.D.
Provider Business Mailing Address
First Line : 20225 ANN ARBOR TRL STE 100
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-2690
Country : US
Telephone Number : 313-949-1411
Fax Number : 313-581-3399
Provider Business Practice Location Address
First Line : 20225 ANN ARBOR TRL STE 100
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-2690
Country : US
Telephone Number : 313-581-0003
Fax Number : 313-581-3399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 04/30/2024

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Directions to “ DR. SAMIR SOTOUHI M.D.” Practice Location

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