MEDICARE: MOHAMED LAYAK

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	363LF0000X	Family Nurse Practitioner	4704324716	MI

General Provider Information

NPI Number	:	1508445115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED LAYAK

Provider Business Mailing Address
First Line	:	36844 CARRIAGE DR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4473
Country	:	US
Telephone Number	:	313-455-2161
Fax Number	:

Provider Business Practice Location Address
First Line	:	8623 N TELEGRAPH RD STE 1
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-1489
Country	:	US
Telephone Number	:	313-561-4540
Fax Number	:

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

Provider Enumeration Date	:	04/02/2021
Last Update Date	:	04/02/2021

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Directions to “ MOHAMED LAYAK ” Practice Location

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