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General NPI Number Information
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NPI Number | 1124292016
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Entity Type | Organization
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Legal Business Name | NASIR UL HAQUE MD & ASSOCIATES PC
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 2677 ELIZABETH LAKE RD #203
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City | WATERFORD
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State | MI
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Zip | 48328-3290
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Country | US
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Telephone | 248-738-0755
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Fax |
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Provider Business Mailing Address
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Address Line | 2677 ELIZABETH LAKE RD #203
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City | WATERFORD
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State | MI
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Zip | 48328-3290
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Country | US
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Telephone | 248-738-0755
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NASIR UL HAQUE
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Credential | M.D.
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Telephone | 248-738-0755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301032577
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License Number State | MI
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