Provider Demographics
NPI:1164201273
Name:DINA KASSAB DO
Entity Type:Organization
Organization Name:DINA KASSAB DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSAB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-782-4000
Mailing Address - Street 1:6043 19 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-2105
Mailing Address - Country:US
Mailing Address - Phone:248-844-4550
Mailing Address - Fax:
Practice Address - Street 1:3950 S ROCHESTER RD STE 1450
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5162
Practice Address - Country:US
Practice Address - Phone:248-844-4550
Practice Address - Fax:248-844-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty