Provider Demographics
NPI:1124361621
Name:SUCCAR, ERIC FAHED (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:FAHED
Last Name:SUCCAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 HIGHLAND RD STE 230
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1973
Mailing Address - Country:US
Mailing Address - Phone:248-254-8900
Mailing Address - Fax:248-599-7191
Practice Address - Street 1:5220 HIGHLAND RD STE 230
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1973
Practice Address - Country:US
Practice Address - Phone:248-254-8900
Practice Address - Fax:248-599-7191
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301117164207Y00000X
TN57091207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology