| Yassir Attalla Pllc | |
|
15450 Northline Rd Ste 102 Southgate MI 48195-2490 | |
| (734) 282-2020 | |
| (734) 282-2002 |
| Full Name | Yassir Attalla Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15450 Northline Rd Ste 102, Southgate, Michigan |
| Authorized Official Name and Position | Yassir A Attalla (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3133993477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yassir Attalla Pllc 15450 Northline Rd Ste 102 Southgate MI 48195-2490 Ph: (734) 720-7270 | Yassir Attalla Pllc 15450 Northline Rd Ste 102 Southgate MI 48195-2490 Ph: (734) 282-2020 |
| NPI Number | 1063625671 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 8820366446 |
|---|---|
| Medicare Enrollment ID | O20170622000957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063625671 | NPI | - | NPPES |
| 4995674 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | YA048664 (Michigan) | Primary |
| Provider Name | Yassir A Attalla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174550974 PECOS PAC ID: 1456242247 Enrollment ID: I20040322001396 |
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