Healthcare Provider Details

I. General information

NPI: 1710771159
Provider Name (Legal Business Name): MEDICAL SPECIALITY GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 CHICAGO RD STE B
WARREN MI
48092-5033
US

IV. Provider business mailing address

5701 CHICAGO RD STE B
WARREN MI
48092-5033
US

V. Phone/Fax

Practice location:
  • Phone: 937-673-3983
  • Fax:
Mailing address:
  • Phone: 937-673-3983
  • Fax:

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: MUHAMMAD K AHSAN
Title or Position: OWNER
Credential: M.D.
Phone: 937-673-3983