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General NPI Number Information
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NPI Number | 1023644242
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Entity Type | Organization
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Legal Business Name | IM CONSULTANT
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 17751 E WARREN AVE
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City | DETROIT
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State | MI
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Zip | 48224-1329
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Country | US
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Telephone | 313-908-7464
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Fax | 313-209-3002
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Provider Business Mailing Address
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Address Line | 4 NOWLIN CT
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City | DEARBORN
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State | MI
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Zip | 48124-3912
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Country | US
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Telephone | 734-462-0340
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Fax | 734-462-0344
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Authorized Official
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Title or Position | PRESIDENT
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Name | AHMAD AHMAD
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Credential | MD
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Telephone | 586-718-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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