Provider Demographics
NPI:1013020254
Name:ATASSI, ADEEB M (MD)
Entity Type:Individual
Prefix:
First Name:ADEEB
Middle Name:M
Last Name:ATASSI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 GREENFIELD RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1802
Mailing Address - Country:US
Mailing Address - Phone:313-563-3332
Mailing Address - Fax:
Practice Address - Street 1:18181 OAKWOOD BLVD
Practice Address - Street 2:SUITE NUMBER 208
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-5032
Practice Address - Country:US
Practice Address - Phone:313-563-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301063251207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93894Medicare UPIN