1801964325 NPI number — SYED M. AHSAN M.D.

Table of content: MRS. CAROLYN R DEXTER OT-A (NPI 1366751083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801964325 NPI number — SYED M. AHSAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHSAN
Provider First Name:
SYED
Provider Middle Name:
M.
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:
1801964325
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HENRY FORD HEALTH SYSTEM
Provider Second Line Business Mailing Address:
24565 HAIG ROAD
Provider Business Mailing Address City Name:
TAYLOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48180
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-291-7800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HENRY FORD HEALTH SYSTEM
Provider Second Line Business Practice Location Address:
24565 HAIG ROAD
Provider Business Practice Location Address City Name:
TAYLOR
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-291-7800
Provider Business Practice Location Address Fax Number:
313-291-7420
Provider Enumeration Date:
12/01/2006

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: 207R00000X , with the licence number:  4301060562 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 4301060562 , 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: SA060562 . This is a "COMMERCIAL-COMMERCIAL NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 700H262220 . This is a "BLUE CROSS-BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: SA060562 . This is a "CHAMPUS-CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 316351010 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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