Healthcare Provider Details

I. General information

NPI: 1245124957
Provider Name (Legal Business Name): IQBAL NASIR MD FRCS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E BIG BEAVER RD
TROY MI
48083-1364
US

IV. Provider business mailing address

525 E BIG BEAVER RD
TROY MI
48083-1364
US

V. Phone/Fax

Practice location:
  • Phone: 248-901-1111
  • Fax:
Mailing address:
  • Phone: 248-901-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: IQBAL NASIR
Title or Position: OWNER
Credential: MD
Phone: 248-901-1111