MEDICARE: DR. QASIM M OMRAN MD

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	4301075275	MI
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	4301075275	MI
3	207RP1001X	Pulmonary Disease Physician	4301075275	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861773491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QASIM M OMRAN MD

Provider Business Mailing Address
First Line	:	51140 SILVERTON
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-7719
Country	:	US
Telephone Number	:	313-808-0602
Fax Number	:	313-808-0602

Provider Business Practice Location Address
First Line	:	35700 WARREN RD
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48185-3808
Country	:	US
Telephone Number	:	734-742-5153
Fax Number	:	734-742-5145

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

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	04/14/2026

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