Provider Demographics
NPI:1528611175
Name:KASSAS, EMAD (MD)
Entity type:Individual
Prefix:DR
First Name:EMAD
Middle Name:
Last Name:KASSAS
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 1:358 E CHICAGO ST STE C
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2072
Mailing Address - Country:US
Mailing Address - Phone:519-819-8583
Mailing Address - Fax:
Practice Address - Street 1:358 E CHICAGO ST STE C
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2072
Practice Address - Country:US
Practice Address - Phone:519-819-8583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095574208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics