Healthcare Provider Details
I. General information
NPI: 1518520469
Provider Name (Legal Business Name): SULEMAN AJAZ JANJUA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/16/2019
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
170 W GENESEE ST
FRANKENMUTH MI
48734-1305
US
IV. Provider business mailing address
4800 S SAGINAW ST STE 1800
FLINT MI
48507-2677
US
V. Phone/Fax
- Phone: 989-652-7344
- Fax: 989-652-7355
- Phone: 810-275-9333
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | D0101526 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | D0101526 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 4301512807 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 4301512807 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: