MEDICARE: ADEL MUZAFFAR IQBAL DPT

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	225100000X	Physical Therapist	5501008819	MI

General Provider Information

NPI Number	:	1396085817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADEL MUZAFFAR IQBAL DPT

Provider Business Mailing Address
First Line	:	3670 NORTHBROOK DR
Second Line	:
City	:	SUPERIOR TOWNSHIP
State	:	MI
Zip	:	48198-8704
Country	:	US
Telephone Number	:	313-737-0832
Fax Number	:

Provider Business Practice Location Address
First Line	:	26000 5 MILE RD
Second Line	:	SUITE 110
City	:	REDFORD
State	:	MI
Zip	:	48239-3236
Country	:	US
Telephone Number	:	313-387-4430
Fax Number	:	313-387-4010

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

Provider Enumeration Date	:	02/20/2013
Last Update Date	:	02/20/2013

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