Healthcare Provider Details

I. General information

NPI: 1740907245
Provider Name (Legal Business Name): BABAR A QADRI INTEGRATIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 08/27/2023
Certification Date: 08/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8528 N CANTON CENTER RD
CANTON MI
48187-1310
US

IV. Provider business mailing address

8528 N CANTON CENTER RD
CANTON MI
48187-1310
US

V. Phone/Fax

Practice location:
  • Phone: 734-414-9944
  • Fax: 862-298-0647
Mailing address:
  • Phone: 734-414-9944
  • Fax: 862-298-0647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BABAR QADRI
Title or Position: OWNER
Credential: PA
Phone: 734-414-9944