Basic Information
| Provider Information | |||||||||
| NPI: | 1447457734 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMAD ALATASSI MD, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43750 GARFIELD RD | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | CLINTON TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480381135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8779969975 | ||||||||
| FaxNumber: | 5862284533 | ||||||||
| Practice Location | |||||||||
| Address1: | 18263 E 10 MILE RD | ||||||||
| Address2: | SUITE D | ||||||||
| City: | ROSEVILLE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480665805 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5867783478 | ||||||||
| FaxNumber: | 5867783496 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2007 | ||||||||
| LastUpdateDate: | 06/18/2013 | ||||||||
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| AuthorizedOfficialLastName: | ALATASSI | ||||||||
| AuthorizedOfficialFirstName: | EMAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5867783478 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | MI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RS0012X | MI | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | MI | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 1528018256 | 01 | MI | NPI EMAD ALATASSI MD | OTHER | EA069292 | 01 | MI | LICENSE EMAD ALATASSI MID | OTHER | 0826142 | 01 | MI | BCBS PIN EMAD ALATASSI MD | OTHER | 290H239650 | 01 | MI | BCBS PIN NUMBER | OTHER | FS087234 | 01 | MI | LICENSE FADI-JEAN SAAD, M | OTHER | 1174573816 | 01 | MI | NPI FADI-JEAN SAAD, MD | OTHER | 0825742 | 01 | MI | BCBS PIN FADIJEAN SAAD MD | OTHER |