Healthcare Provider Details

I. General information

NPI: 1114877230
Provider Name (Legal Business Name): MOHAMMAD HAMZA IQBAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45202 DANBURY RD
CANTON MI
48188-1047
US

IV. Provider business mailing address

45202 DANBURY RD
CANTON MI
48188-1047
US

V. Phone/Fax

Practice location:
  • Phone: 734-377-8226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: