Provider Demographics
NPI:1790256980
Name:FAIZA MASOUD MD PC
Entity Type:Organization
Organization Name:FAIZA MASOUD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FAIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-739-0283
Mailing Address - Street 1:26541 ANCHORAGE CT
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-2125
Mailing Address - Country:US
Mailing Address - Phone:248-739-0283
Mailing Address - Fax:
Practice Address - Street 1:33330 PALMER RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5529
Practice Address - Country:US
Practice Address - Phone:248-739-0283
Practice Address - Fax:734-729-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty