MEDICARE: SAMI ATASSI 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
1	207RH0000X	Hematology (Internal Medicine) Physician	47734	IA
2	207RH0003X	Hematology & Oncology Physician	036.091724	IL
3	207RH0003X	Hematology & Oncology Physician	01060203A	IN

General Provider Information

NPI Number	:	1801830534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMI ATASSI MD

Provider Business Mailing Address
First Line	:	PO BOX 781076 STE 400
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48278-0001
Country	:	US
Telephone Number	:	317-528-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	8955 W 400 N
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-9330
Country	:	US
Telephone Number	:	219-861-5800
Fax Number	:	219-861-5543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/09/2024

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Directions to “ SAMI ATASSI MD” Practice Location

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