Healthcare Provider Details

I. General information

NPI: 1619004512
Provider Name (Legal Business Name): AUBURN SLEEP LABS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 01/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27101 SCHOENHERR RD SUITE 200
WARREN MI
48088-4730
US

IV. Provider business mailing address

27101 SCHOENHERR RD SUITE 200
WARREN MI
48088-4730
US

V. Phone/Fax

Practice location:
  • Phone: 586-754-7533
  • Fax: 586-754-7227
Mailing address:
  • Phone: 586-754-7533
  • Fax: 586-754-7227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. VAQAR SIDDIQUI
Title or Position: MANAGING PHYSICIAN
Credential: MD
Phone: 586-754-7533