Healthcare Provider Details

I. General information

NPI: 1235177718
Provider Name (Legal Business Name): CANCER & TRANSPLANT CONSULTANTS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 03/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MONROE ST STE 203
DEARBORN MI
48124-2926
US

IV. Provider business mailing address

7105 ALLEN RD
ALLEN PARK MI
48101-2009
US

V. Phone/Fax

Practice location:
  • Phone: 313-388-6299
  • Fax: 313-388-6328
Mailing address:
  • Phone: 313-388-6299
  • Fax: 313-388-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number4301051771
License Number StateMI

VIII. Authorized Official

Name: DR. FEROZE A MOMIN
Title or Position: PRESIDENT/PHYSICIAN
Credential: MD
Phone: 313-388-6299