Provider Demographics
NPI:1033127741
Name:ALASSI, OSAMA M (MD)
Entity Type:Individual
Prefix:
First Name:OSAMA
Middle Name:M
Last Name:ALASSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1848
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-898-9060
Practice Address - Fax:248-898-9054
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2023-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301077763207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OA077763OtherCHAMPUS-CHAMPUS
OA077763OtherCOMMERCIAL-COMMERCIAL NUMBER
OA077763OtherCHAMPUS-CHAMPUS