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General NPI Number Information
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NPI Number | 1730418831
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Entity Type | Organization
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Legal Business Name | NADEEM ULLAH MD PLC
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 200 SUMMIT AVE STE B
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City | JACKSON
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State | MI
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Zip | 49201-2465
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Country | US
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Telephone | 517-768-1225
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Fax | 517-768-1250
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Provider Business Mailing Address
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Address Line | 1701 LAKE LANSING RD STE 100
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City | LANSING
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State | MI
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Zip | 48912-3798
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Country | US
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Telephone | 517-485-9676
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Fax | 517-485-2622
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Authorized Official
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Title or Position | CREDENTIALING
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Name | KRISTINA ROWE
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Credential |
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Telephone | 517-485-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301068267
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License Number State | MI
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