Provider Demographics
NPI:1437359536
Name:ISSAWI, EMAN FAROUK (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:EMAN
Middle Name:FAROUK
Last Name:ISSAWI
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2900 HANNAH BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5384
Mailing Address - Country:US
Mailing Address - Phone:517-332-0440
Mailing Address - Fax:517-332-1724
Practice Address - Street 1:2900 HANNAH BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5384
Practice Address - Country:US
Practice Address - Phone:517-332-0440
Practice Address - Fax:517-332-1724
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601004171363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant