1346414083 NPI number — MASROOR HAQ, MD, PLLC

Table of content: (NPI 1346414083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346414083 NPI number — MASROOR HAQ, MD, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MASROOR HAQ, MD, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1346414083
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
950 W AVON RD
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
ROCHESTER HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48307-2761
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-652-3310
Provider Business Mailing Address Fax Number:
248-652-6971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
950 W AVON RD
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
ROCHESTER HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48307-2761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-652-3310
Provider Business Practice Location Address Fax Number:
248-652-6971
Provider Enumeration Date:
04/14/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAQ
Authorized Official First Name:
MASROOR
Authorized Official Middle Name:
Authorized Official Title or Position:
PROPRIETOR
Authorized Official Telephone Number:
248-652-3310

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  4301060252 , 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)