Provider Demographics
NPI:1518176296
Name:KASEB, AHMED O (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:O
Last Name:KASEB
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 1:5100 W BLOOMFIELD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2407
Mailing Address - Country:US
Mailing Address - Phone:248-943-4473
Mailing Address - Fax:313-916-7911
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:CFP-5
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-3788
Practice Address - Fax:313-916-7911
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078242207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology