Healthcare Provider Details

I. General information

NPI: 1376110213
Provider Name (Legal Business Name): ABRAR MOHAMMED HAIDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N PERRY ST
PONTIAC MI
48342-2217
US

IV. Provider business mailing address

50 N PERRY ST
PONTIAC MI
48342-2217
US

V. Phone/Fax

Practice location:
  • Phone: 248-338-5645
  • Fax: 248-338-5547
Mailing address:
  • Phone: 248-338-5645
  • Fax: 248-338-5547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number5101028300
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: