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General NPI Number Information
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NPI Number | 1013377027
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Entity Type | Organization
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Legal Business Name | ALLEN PARK INTERNAL MEDICINE P.C.
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 14551 SOUTHFIELD RD SUITE 1
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City | ALLEN PARK
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State | MI
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Zip | 48101-2687
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Country | US
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Telephone | 313-388-0910
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Fax | 313-388-6630
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Provider Business Mailing Address
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Address Line | 14551 SOUTHFIELD RD SUITE 1
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City | ALLEN PARK
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State | MI
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Zip | 48101-2687
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Country | US
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Telephone | 313-388-0910
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Fax | 313-388-6630
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NUSRAT Z. RAHMAN
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Credential | M.D.
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Telephone | 313-590-7705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301043492
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License Number State | MI
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