MEDICARE: FATIMA DIAB HACHEM

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	363LF0000X	Family Nurse Practitioner	4704326896	MI

General Provider Information

NPI Number	:	1811624109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA DIAB HACHEM

Provider Business Mailing Address
First Line	:	400 RENAISSANCE CTR STE 2600
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48243-1599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25325 FORD RD STE 200
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48128-1086
Country	:	US
Telephone Number	:	313-887-7774
Fax Number	:

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

Provider Enumeration Date	:	08/05/2022
Last Update Date	:	12/14/2025

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Directions to “ FATIMA DIAB HACHEM ” Practice Location

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