MEDICARE: DR. NAZIR AHMED PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501004934	MI

General Provider Information

NPI Number	:	1386642817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAZIR AHMED PT

Provider Business Mailing Address
First Line	:	PO BOX 2065
Second Line	:
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-1065
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2799 W GRAND BLVD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-2608
Country	:	US
Telephone Number	:	313-916-2600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	03/19/2021

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Directions to “ DR. NAZIR AHMED PT” Practice Location

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