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NPI Code Detail

MEDICARE: REDFORD PRIMARY CARE PC

MEDICARE: REDFORD PRIMARY CARE PC
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
1207R00000XInternal Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number : 1164891362
Entity Type Code : Organization
Provider Name (Legal Business Name) : REDFORD PRIMARY CARE PC
Provider Business Mailing Address
First Line : 14671 TELEGRAPH RD
Second Line :
City : REDFORD
State : MI
Zip : 48239-3300
Country : US
Telephone Number : 734-560-9451
Fax Number : 313-948-3040
Provider Business Practice Location Address
First Line : 14671 TELEGRAPH RD
Second Line :
City : REDFORD
State : MI
Zip : 48239-3300
Country : US
Telephone Number : 734-560-9451
Fax Number : 313-948-3040
Authorized Official
Title or Position : MD
Name : ZAHOORUL HASSAN
Credential : MD
Telephone Number : 734-560-9451
Provider Enumeration Date : 09/17/2015
Last Update Date : 09/17/2015

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Directions to “REDFORD PRIMARY CARE PC ” Practice Location

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