MEDICARE: MAHMOUD SAAD TARSIN 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	208800000X	Urology Physician	4301086902	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4301086902	OTHER	MI	MI LICENSE

General Provider Information

NPI Number	:	1912202656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHMOUD SAAD TARSIN MD

Provider Business Mailing Address
First Line	:	4675 DEPARTMENT
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60122-0021
Country	:	US
Telephone Number	:	810-720-5715
Fax Number	:	810-732-0891

Provider Business Practice Location Address
First Line	:	4160 JOHN R ST
Second Line	:	SUITE 1021
City	:	DETROIT
State	:	MI
Zip	:	48201-2020
Country	:	US
Telephone Number	:	313-966-9852
Fax Number	:	313-745-8222

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

Provider Enumeration Date	:	01/11/2011
Last Update Date	:	01/11/2011

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Directions to “ MAHMOUD SAAD TARSIN MD” Practice Location

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