Provider Demographics
NPI:1619262276
Name:FATEH, NUMAN (DO)
Entity type:Individual
Prefix:
First Name:NUMAN
Middle Name:
Last Name:FATEH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5680 BOW POINTE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-5407
Mailing Address - Country:US
Mailing Address - Phone:248-922-6650
Mailing Address - Fax:
Practice Address - Street 1:5680 BOW POINTE DR STE 202
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-5407
Practice Address - Country:US
Practice Address - Phone:248-922-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-12
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026522207RH0003X
PAOS018872207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology