Basic Information
| Provider Information | |||||||||
| NPI: | 1184158677 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YASSIN | ||||||||
| FirstName: | AHMED | ||||||||
| MiddleName: | S M | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.B.B.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 445 W BARRY AVE APT 531 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606575591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3123587345 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4201 ST. ANTOINE ST., 9C-UHC, | ||||||||
| Address2: | DMC/WSU, GRADUATE MEDICAL EDUCATION | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137455146 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2017 | ||||||||
| LastUpdateDate: | 04/12/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.