1114115409 NPI number — MUHAMMAD FAISAL ASLAM M.D.

Table of content: MUHAMMAD FAISAL ASLAM M.D. (NPI 1114115409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114115409 NPI number — MUHAMMAD FAISAL ASLAM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASLAM
Provider First Name:
MUHAMMAD
Provider Middle Name:
FAISAL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114115409
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22151 MOROSS RD
Provider Second Line Business Mailing Address:
SUITE 313
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48236-2167
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-343-3494
Provider Business Mailing Address Fax Number:
313-343-4932

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22151 MOROSS RD
Provider Second Line Business Practice Location Address:
SUITE 313
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48236-2167
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-343-3494
Provider Business Practice Location Address Fax Number:
313-343-4932
Provider Enumeration Date:
10/11/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VF0040X , with the licence number:  4301106942 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: 430116942 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0H208910 . This is a "BLUE CROSS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".