Healthcare Provider Details

I. General information

NPI: 1326978511
Provider Name (Legal Business Name): QASIM QUNBER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 S INDUSTRIAL DR
SALINE MI
48176-9493
US

IV. Provider business mailing address

140 S INDUSTRIAL DR
SALINE MI
48176-9493
US

V. Phone/Fax

Practice location:
  • Phone: 734-316-2268
  • Fax: 734-236-6030
Mailing address:
  • Phone: 734-316-2268
  • Fax: 734-236-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAG05260037
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: