Healthcare Provider Details

I. General information

NPI: 1942339874
Provider Name (Legal Business Name): NAZIMA S HAFEEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 NOWLAND CT
CANTON MI
48188-1797
US

IV. Provider business mailing address

1195 PADDINGTON ROAD
CANTON MI
48187
US

V. Phone/Fax

Practice location:
  • Phone: 419-509-4249
  • Fax:
Mailing address:
  • Phone: 734-981-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.149640
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: