MEDICARE: MEDICAL SPECIALITY GROUP PLLC

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	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1710771159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL SPECIALITY GROUP PLLC

Provider Business Mailing Address
First Line	:	5701 CHICAGO RD STE B
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48092-5033
Country	:	US
Telephone Number	:	937-673-3983
Fax Number	:

Provider Business Practice Location Address
First Line	:	5701 CHICAGO RD STE B
Second Line	:
City	:	WARREN
State	:	MI
Zip	:	48092-5033
Country	:	US
Telephone Number	:	937-673-3983
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MUHAMMAD K AHSAN
Credential	:	M.D.
Telephone Number	:	937-673-3983

Provider Enumeration Date	:	04/09/2025
Last Update Date	:	04/09/2025

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