Healthcare Provider Details

I. General information

NPI: 1699461285
Provider Name (Legal Business Name): MOHAMMAD ARAGHINIKNAM DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2895 HAVERFORD DR
CANTON MI
48188-3303
US

IV. Provider business mailing address

2895 HAVERFORD DR
CANTON MI
48188-3303
US

V. Phone/Fax

Practice location:
  • Phone: 763-291-7964
  • Fax: 763-291-7964
Mailing address:
  • Phone: 763-291-7964
  • Fax: 763-291-7964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5951001498
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: