Provider Demographics
NPI:1154554590
Name:SATTAR, ASSAD
Entity type:Individual
Prefix:
First Name:ASSAD
Middle Name:
Last Name:SATTAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 GREENFIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-6004
Mailing Address - Country:US
Mailing Address - Phone:313-945-9000
Mailing Address - Fax:313-945-7500
Practice Address - Street 1:6050 GREENFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-6004
Practice Address - Country:US
Practice Address - Phone:313-945-9000
Practice Address - Fax:313-945-9000
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095016207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI46-4805855OtherTIN