Provider Demographics
NPI:1184158677
Name:YASSIN, AHMED S M (MBBS)
Entity type:Individual
Prefix:MR
First Name:AHMED
Middle Name:S M
Last Name:YASSIN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 W BARRY AVE APT 531
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5591
Mailing Address - Country:US
Mailing Address - Phone:312-358-7345
Mailing Address - Fax:
Practice Address - Street 1:4201 ST. ANTOINE ST., 9C-UHC,
Practice Address - Street 2:DMC/WSU, GRADUATE MEDICAL EDUCATION
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-5146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program