Provider Demographics
NPI:1649241910
Name:TURFAH, FUAD HASSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FUAD
Middle Name:HASSAN
Last Name:TURFAH
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 1:1811 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2924
Mailing Address - Country:US
Mailing Address - Phone:313-565-4010
Mailing Address - Fax:313-565-7208
Practice Address - Street 1:1811 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2924
Practice Address - Country:US
Practice Address - Phone:313-565-4010
Practice Address - Fax:313-565-7208
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301058685174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI103439744Medicaid
MIP13840001Medicare PIN
MIF95799Medicare UPIN