Healthcare Provider Details

I. General information

NPI: 1871281188
Provider Name (Legal Business Name): ADAM MUNTASER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 SAINT ANTOINE ST OFC
DETROIT MI
48201-2153
US

IV. Provider business mailing address

22362 NORTHWOOD TRL
STRONGSVILLE OH
44149-2880
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-5147
  • Fax:
Mailing address:
  • Phone: 440-223-6858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0106706
License Number StateMD
# 2
Primary TaxonomyN
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: