Provider Demographics
NPI:1467202663
Name:GAMMO, FAHIMA
Entity Type:Individual
Prefix:MRS
First Name:FAHIMA
Middle Name:
Last Name:GAMMO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:FAHIMA
Other - Middle Name:
Other - Last Name:GAMMO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13135 FLORENTINE DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-4116
Mailing Address - Country:US
Mailing Address - Phone:586-215-2260
Mailing Address - Fax:
Practice Address - Street 1:13135 FLORENTINE DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-4116
Practice Address - Country:US
Practice Address - Phone:586-215-2260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker