1467408344 NPI number — MUHAMMAD K AHSAN MD

Table of content: MUHAMMAD K AHSAN MD (NPI 1467408344)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467408344 NPI number — MUHAMMAD K AHSAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHSAN
Provider First Name:
MUHAMMAD
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1467408344
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1221 BOWERS ST
Provider Second Line Business Mailing Address:
UNIT 2653
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48012-7107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-200-7756
Provider Business Mailing Address Fax Number:
248-281-3535

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1221 BOWERS ST
Provider Second Line Business Practice Location Address:
UNIT 2653
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48012-7107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-200-7756
Provider Business Practice Location Address Fax Number:
248-281-3535
Provider Enumeration Date:
05/25/2006

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: 208VP0000X , with the licence number:  4301097463 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: 35083611A , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000000336858 . This is a "BCBS CLARK COUNTY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000336869 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00303491 . This is a "RAIL ROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000509617 . This is a "BCBS FAIRFIELD HOS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2463543 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00157619 . This is a "MEDICARE RR" identifier . This identifiers is of the category "OTHER".




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