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General NPI Number Information
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NPI Number | 1336161280
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Entity Type | Organization
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Legal Business Name | AGHA INTERNAL MEDICINE ASSOCIATES PC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 15604 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48154-2852
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Country | US
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Telephone | 734-855-4176
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Fax | 734-855-4178
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Provider Business Mailing Address
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Address Line | 15604 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48154-2852
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Country | US
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Telephone | 734-855-4176
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Fax | 734-855-4178
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | DR. HOOMAN AGHA
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Credential | MD
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Telephone | 734-855-4176
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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 | HA079451
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License Number State | MI
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