Provider Demographics
NPI:1689830192
Name:ADEL, JOSEPH GHASSAN (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:GHASSAN
Last Name:ADEL
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 1:4677 TOWNE CENTRE RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2846
Mailing Address - Country:US
Mailing Address - Phone:855-298-9888
Mailing Address - Fax:989-497-3128
Practice Address - Street 1:4677 TOWNE CENTRE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2846
Practice Address - Country:US
Practice Address - Phone:855-298-9888
Practice Address - Fax:989-497-3128
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125051383174400000X
MI4301106211207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL125051383OtherSTATE LICENSE NUMBER
MI4301106211OtherMI LICENSE