MEDICARE: DR. FEROZE A MOMIN MD

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	207RH0003X	Hematology & Oncology Physician	4301051771	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	900003803	OTHER	MI	RAILROAD MEDICARE
9	CH9161	OTHER	MI	RAILROAD MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01004356	OTHER	MI	HEALTH PLUS
2	F25010	OTHER	MI	HAP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	48121	OTHER	MI	OMNICARE
7	014995	OTHER	MI	MIDWEST HEALTH PLAN
8	1105020291	OTHER	MI	BCBS
10	110E002110	OTHER	MI	BCBS
11	124278	OTHER	MI	GREAT LAKES
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396728507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FEROZE A MOMIN MD

Provider Business Mailing Address
First Line	:	13530 MICHIGAN AVE
Second Line	:	STE 242
City	:	DEARBORN
State	:	MI
Zip	:	48126-3575
Country	:	US
Telephone Number	:	313-388-6299
Fax Number	:	313-388-6328

Provider Business Practice Location Address
First Line	:	2021 MONROE ST STE 203
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-2926
Country	:	US
Telephone Number	:	313-388-6299
Fax Number	:	313-388-6328

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	02/24/2025

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Directions to “ DR. FEROZE A MOMIN MD” Practice Location

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