Healthcare Provider Details

I. General information

NPI: 1073544912
Provider Name (Legal Business Name): M.A.MUNIR MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11400 JOSEPH CAMPAU ST
HAMTRAMCK MI
48212-3041
US

IV. Provider business mailing address

11400 JOSEPH CAMPAU ST
HAMTRAMCK MI
48212-3041
US

V. Phone/Fax

Practice location:
  • Phone: 313-366-5500
  • Fax: 313-366-5505
Mailing address:
  • Phone: 313-366-5500
  • Fax: 313-366-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301068351
License Number StateMI

VIII. Authorized Official

Name: DR. MUHAMMAD ASIM MUNIR
Title or Position: OWNER
Credential: MD
Phone: 313-366-5500