Healthcare Provider Details

I. General information

NPI: 1013984269
Provider Name (Legal Business Name): HAMEEM CHANGEZI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 03/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5084 VILLA LINDE PKWY SUITE 6
FLINT MI
48532-3422
US

IV. Provider business mailing address

5084 VILLA LINDE PKWY SUITE 6
FLINT MI
48532-3422
US

V. Phone/Fax

Practice location:
  • Phone: 810-600-3399
  • Fax: 810-600-3398
Mailing address:
  • Phone: 810-600-3399
  • Fax: 810-600-3398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301064119
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: