1982731337 NPI number — SAMEENA M. ZAHOOR MD PLLC

Table of content: (NPI 1982731337)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982731337 NPI number — SAMEENA M. ZAHOOR MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAMEENA M. ZAHOOR 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:
1982731337
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1060 MILBROOK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48188-5086
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-397-0073
Provider Business Mailing Address Fax Number:
734-398-5580

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1651 S VENOY RD
Provider Second Line Business Practice Location Address:
SOUTH SUITE
Provider Business Practice Location Address City Name:
WESTLAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48186-5514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-721-7055
Provider Business Practice Location Address Fax Number:
734-721-6955
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZAHOOR
Authorized Official First Name:
SAMEENA
Authorized Official Middle Name:
MASOOD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
734-721-7055

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4630332 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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