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General NPI Number Information
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NPI Number | 1689694945
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Entity Type | Individual
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Provider Name | SYED MASHOOQ AHMAD MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 30901 PALMER RD
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City | WESTLAND
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State | MI
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Zip | 48186-9529
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Country | US
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Telephone | 734-367-8403
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Fax | 734-722-9524
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Provider Business Mailing Address
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Address Line | 16668 WHITE HAVEN DR
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City | NORTHVILLE
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State | MI
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Zip | 48168-2330
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Country | US
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Telephone | 734-420-0239
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301048105
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License Number State | MI
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