MEDICARE: PSYCH ONE PLLC

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	2084P0800X	Psychiatry Physician	4301085763	MI

General Provider Information

NPI Number	:	1144527524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCH ONE PLLC

Provider Business Mailing Address
First Line	:	2150 ASSOCIATION DR STE 100
Second Line	:
City	:	OKEMOS
State	:	MI
Zip	:	48864-6039
Country	:	US
Telephone Number	:	517-999-1104
Fax Number	:	517-879-0403

Provider Business Practice Location Address
First Line	:	2150 ASSOCIATION DR STE 100
Second Line	:
City	:	OKEMOS
State	:	MI
Zip	:	48864-6039
Country	:	US
Telephone Number	:	517-999-1104
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ZULFIQAR AHMED
Credential	:	MD
Telephone Number	:	517-316-6241

Provider Enumeration Date	:	02/20/2011
Last Update Date	:	06/03/2024

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Directions to “PSYCH ONE PLLC ” Practice Location

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