1073544912 NPI number — M.A.MUNIR MD PC

Table of content: (NPI 1073544912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073544912 NPI number — M.A.MUNIR MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
M.A.MUNIR MD PC
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:
1073544912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11400 JOSEPH CAMPAU ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMTRAMCK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48212-3041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-366-5500
Provider Business Mailing Address Fax Number:
313-366-5505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11400 JOSEPH CAMPAU ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMTRAMCK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48212-3041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-366-5500
Provider Business Practice Location Address Fax Number:
313-366-5505
Provider Enumeration Date:
07/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MUNIR
Authorized Official First Name:
MUHAMMAD
Authorized Official Middle Name:
ASIM
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
313-366-5500

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  4301068351 , 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: 110H232350 . This is a "BC GROUP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 110H232350 . This is a "BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 030195 . This is a "MIDWEST HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4891580 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4974262 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: DG7462 . This is a "RAILROAD MEDICARE GROUP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1073544912 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1108261692 . This is a "BCBS BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5211840 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com