Healthcare Provider Details

I. General information

NPI: 1467408344
Provider Name (Legal Business Name): MUHAMMAD K AHSAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 BOWERS ST UNIT 2653
BIRMINGHAM MI
48012-7107
US

IV. Provider business mailing address

1221 BOWERS ST UNIT 2653
BIRMINGHAM MI
48012-7107
US

V. Phone/Fax

Practice location:
  • Phone: 248-200-7756
  • Fax: 248-281-3535
Mailing address:
  • Phone: 248-200-7756
  • Fax: 248-281-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number4301097463
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35083611A
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: