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NPI Code Detail

MEDICARE: FAZAL AHMAD MD

MEDICARE: FAZAL AHMAD 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
1207RP1001XPulmonary Disease Physician4301033328MI

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 : 1740243757
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAZAL AHMAD MD
Provider Business Mailing Address
First Line : 42557 WOODWARD AVE
Second Line : SUITE 130
City : BLOOMFIELD HILLS
State : MI
Zip : 48304-5206
Country : US
Telephone Number : 248-322-3088
Fax Number : 248-322-4175
Provider Business Practice Location Address
First Line : 3100 CROSS CREEK PKWY
Second Line : SUITE 210B
City : AUBURN HILLS
State : MI
Zip : 48326-2774
Country : US
Telephone Number : 248-335-1110
Fax Number : 248-335-6129
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/02/2014

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