MEDICARE: MOUHIB AYAS 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	207RG0100X	Gastroenterology Physician	MA055501	MI
2	2080P0206X	Pediatric Gastroenterology Physician	4301055501	MI

General Provider Information

NPI Number	:	1811928047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOUHIB AYAS MD

Provider Business Mailing Address
First Line	:	26901 BEAUMONT BLVD STE 3D
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	44199 DEQUINDRE RD STE 615
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-1128
Country	:	US
Telephone Number	:	248-964-9660
Fax Number	:	248-964-9665

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	10/23/2020

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