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General NPI Number Information
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NPI Number | 1649621897
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Entity Type | Individual
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Provider Name | JUNAID AHMED SOOMRO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 44405 WOODWARD AVE
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City | PONTIAC
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State | MI
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Zip | 48341-5023
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Country | US
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Telephone | 248-858-6233
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Fax |
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Provider Business Mailing Address
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Address Line | 834 GOLF DR APT 201
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City | PONTIAC
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State | MI
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Zip | 48341-2382
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Country | US
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Telephone | 248-722-1080
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101282463
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301109525
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License Number State | MI
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