Healthcare Provider Details

I. General information

NPI: 1073826293
Provider Name (Legal Business Name): RUBINA AHMED, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 07/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12701 TELEGRAPH RD 105
TAYLOR MI
48180-6847
US

IV. Provider business mailing address

12701 TELEGRAPH RD 105
TAYLOR MI
48180-6847
US

V. Phone/Fax

Practice location:
  • Phone: 734-287-0700
  • Fax:
Mailing address:
  • Phone: 734-287-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number071462
License Number StateMI

VIII. Authorized Official

Name: RUBINA AHMED
Title or Position: PRESIDENT
Credential: M.D.
Phone: 734-718-7676