Provider Demographics
NPI:1003013913
Name:FAKIH, MONA Y (DO)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:Y
Last Name:FAKIH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25150 FORD ROAD STE 200
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-4124
Mailing Address - Country:US
Mailing Address - Phone:313-277-0400
Mailing Address - Fax:
Practice Address - Street 1:25150 FORD ROAD SUITE 200
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-4001
Practice Address - Country:US
Practice Address - Phone:313-277-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017198207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology