Provider Demographics
NPI:1861466500
Name:ASMAR, SAMI ELIAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMI
Middle Name:ELIAS
Last Name:ASMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMI
Other - Middle Name:ELIAS
Other - Last Name:AL ASSMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:44645 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1321
Mailing Address - Country:US
Mailing Address - Phone:586-580-0280
Mailing Address - Fax:586-580-0281
Practice Address - Street 1:44645 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1321
Practice Address - Country:US
Practice Address - Phone:586-580-0280
Practice Address - Fax:586-580-0281
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-16
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064720207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4649370Medicaid
MIG61684Medicare UPIN
MI0N83640Medicare ID - Type Unspecified