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General NPI Number Information
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NPI Number | 1134358245
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Entity Type | Individual
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Provider Name | MOHAMMAD A.A.M.S. ABUSEDERA MBBCH,MSC.PHD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DR CVC 5582 / 5868
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 734-232-5060
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Fax | 734-232-5055
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Provider Business Mailing Address
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Address Line | 1108 MAIDEN LANE CT 102
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City | ANN ARBOR
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State | MI
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Zip | 48105-1989
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Country | US
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Telephone | 443-248-2708
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Fax | 734-232-5055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 4301094742
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License Number State | MI
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