Healthcare Provider Details

I. General information

NPI: 1588278436
Provider Name (Legal Business Name): USMAN AHMED MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43050 FORD RD STE 170
CANTON MI
48187-3359
US

IV. Provider business mailing address

43050 FORD RD STE 170
CANTON MI
48187-3359
US

V. Phone/Fax

Practice location:
  • Phone: 734-404-6168
  • Fax:
Mailing address:
  • Phone: 734-404-6168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: USMAN AHMED
Title or Position: OWNER
Credential: MD
Phone: 734-846-2988