Provider Demographics
NPI:1063423317
Name:AHMAD, NASEER (MD)
Entity type:Individual
Prefix:
First Name:NASEER
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23800 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2560
Mailing Address - Country:US
Mailing Address - Phone:248-471-3300
Mailing Address - Fax:248-471-4200
Practice Address - Street 1:23800 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2560
Practice Address - Country:US
Practice Address - Phone:248-471-3300
Practice Address - Fax:248-471-4200
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINA041293207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI06311252111Medicare ID - Type Unspecified
B46436Medicare UPIN