Healthcare Provider Details

I. General information

NPI: 1457745150
Provider Name (Legal Business Name): STRATEGY ANESTHESIA MICHIGAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13460 FORT ST
SOUTHGATE MI
48195-1138
US

IV. Provider business mailing address

PO BOX 758648
BALTIMORE MD
21275-8648
US

V. Phone/Fax

Practice location:
  • Phone: 703-665-3046
  • Fax: 703-991-7269
Mailing address:
  • Phone: 703-665-3046
  • Fax: 703-991-7269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KASHIF IRFAN
Title or Position: OWNER
Credential: MD
Phone: 703-665-3046