Healthcare Provider Details

I. General information

NPI: 1780639450
Provider Name (Legal Business Name): NAVEED MAHFOOZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 W CARO RD
CARO MI
48723-9260
US

IV. Provider business mailing address

1525 W CARO RD
CARO MI
48723-9686
US

V. Phone/Fax

Practice location:
  • Phone: 989-672-2100
  • Fax: 989-672-0748
Mailing address:
  • Phone: 989-672-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301059644
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301059644
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: