=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912930413
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A&S REHABILITATION SPECIALISTS, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31830 RYAN RD
-----------------------------------------------------
City | WARREN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48092-3767
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-977-6700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1646 CRESTLINE CT
-----------------------------------------------------
City | ROCHESTER HILLS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48307-3410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-265-4080
-----------------------------------------------------
Fax | 248-265-4082
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AHMED AYOUB
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 248-265-4080
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 4301079280
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------