MEDICARE: PULMONARY & SLEEP MEDICINE CENTER PC

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	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1821265455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULMONARY & SLEEP MEDICINE CENTER PC

Provider Business Mailing Address
First Line	:	13201 W WARREN AVE
Second Line	:	STE #5
City	:	DEARBORN
State	:	MI
Zip	:	48126-1414
Country	:	US
Telephone Number	:	248-830-6697
Fax Number	:

Provider Business Practice Location Address
First Line	:	13201 WARREN AVE
Second Line	:	SUITE 5
City	:	DEARBORN
State	:	MI
Zip	:	48126-1414
Country	:	US
Telephone Number	:	248-830-6697
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ASADALLAH MOHAMMAD
Credential	:	M.D.
Telephone Number	:	248-830-6697

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	05/13/2008

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