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General NPI Number Information
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NPI Number | 1396728507
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Entity Type | Individual
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Provider Name | FEROZE A MOMIN MD
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Gender | Male
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 2021 MONROE ST STE 203
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City | DEARBORN
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State | MI
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Zip | 48124-2926
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Country | US
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Telephone | 313-388-6299
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Fax | 313-388-6328
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Provider Business Mailing Address
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Address Line | 13530 MICHIGAN AVE STE 242
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City | DEARBORN
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State | MI
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Zip | 48126-3575
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Country | US
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Telephone | 313-388-6299
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Fax | 313-388-6328
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 4301051771
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License Number State | MI
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