Healthcare Provider Details

I. General information

NPI: 1528017555
Provider Name (Legal Business Name): HUSAIN ARASTU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28771 HOOVER RD
WARREN MI
48093-4152
US

IV. Provider business mailing address

28771 HOOVER RD
WARREN MI
48093-4152
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-0100
  • Fax: 586-573-3645
Mailing address:
  • Phone: 586-573-0100
  • Fax: 586-573-3645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number4301047816
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: