MEDICARE: DR. REZA M TEHRANI M.D.

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	RT062803	MI
2	207RP1001X	Pulmonary Disease Physician	RT062803	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841298825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REZA M TEHRANI M.D.

Provider Business Mailing Address
First Line	:	363 FREMONT ST STE 100
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49017-3395
Country	:	US
Telephone Number	:	269-969-6100
Fax Number	:	269-969-6102

Provider Business Practice Location Address
First Line	:	363 FREMONT ST STE 100
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49017-3395
Country	:	US
Telephone Number	:	269-969-6100
Fax Number	:	269-969-6102

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	04/06/2015

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