Healthcare Provider Details

I. General information

NPI: 1790104057
Provider Name (Legal Business Name): NAHEED RAFIQ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3245 N ADRIAN HWY STE A
ADRIAN MI
49221
US

IV. Provider business mailing address

1 SEAGATE STE 800
TOLEDO OH
43604-1558
US

V. Phone/Fax

Practice location:
  • Phone: 517-366-5010
  • Fax: 517-366-5014
Mailing address:
  • Phone: 517-366-5010
  • Fax: 517-366-5014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35130968
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301113569
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: