MEDICARE: MOHAMMED ZIAAL HAQUE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301061429	MI
2	207R00000X	Internal Medicine Physician	4301061429	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063484053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMED ZIAAL HAQUE M.D.

Provider Business Mailing Address
First Line	:	14071 E 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-2335
Country	:	US
Telephone Number	:	313-371-2828
Fax Number	:

Provider Business Practice Location Address
First Line	:	14071 E 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-2335
Country	:	US
Telephone Number	:	313-371-2828
Fax Number	:	313-371-9120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	05/24/2021

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