MEDICARE: TRICITY LUNG ASSOCIATES PLC

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	207RS0012X	Sleep Medicine (Internal Medicine) Physician	SA4130592	MI

General Provider Information

NPI Number	:	1386035012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRICITY LUNG ASSOCIATES PLC

Provider Business Mailing Address
First Line	:	640 S TRUMBULL ST
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-7656
Country	:	US
Telephone Number	:	989-893-7460
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 S TRUMBULL ST
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-7656
Country	:	US
Telephone Number	:	989-893-7460
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. SAAD S AHMAD
Credential	:	M.D.
Telephone Number	:	989-893-7460

Provider Enumeration Date	:	02/17/2015
Last Update Date	:	02/17/2015

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