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General NPI Number Information
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NPI Number | 1982361846
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Entity Type | Individual
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Provider Name | FURWA HAQUE RDN
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Gender | Female
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Dates
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Enumeration Date | 11/25/2021
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 2799 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48202-2608
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Country | US
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Telephone | 313-916-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 13329 DENVER CIR S
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-1632
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86090013
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License Number State | MI
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