Healthcare Provider Details

I. General information

NPI: 1073443024
Provider Name (Legal Business Name): MAH NOOR AHMAD M.B.B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 ST. ANTOINE STREET, SUITE 9C
DETROIT MI
48201
US

IV. Provider business mailing address

192 IVERSON CLOSE
RED DEAR ALBERTA
T4R 3M8
CA

V. Phone/Fax

Practice location:
  • Phone: 313-745-6047
  • Fax: 313-966-0880
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 StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: