1598701740 NPI number — DR. MOHAMMAD S ZAMAN MD

Table of content: DR. MOHAMMAD S ZAMAN MD (NPI 1598701740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598701740 NPI number — DR. MOHAMMAD S ZAMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAMAN
Provider First Name:
MOHAMMAD
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
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:
1598701740
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 528
Provider Second Line Business Mailing Address:
106 S LOWE ST
Provider Business Mailing Address City Name:
DOWAGIAC
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49047-0528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
269-782-5065
Provider Business Mailing Address Fax Number:
269-782-6613

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 S LOWE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWAGIAC
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49047-0528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
269-782-5065
Provider Business Practice Location Address Fax Number:
269-782-6613
Provider Enumeration Date:
06/22/2006

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: 208600000X , with the licence number:  4301031944 , 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: 1246462 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0145933 . This is a "BCBS OF MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 103034 . This is a "GREAT LAKES HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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