Provider Demographics
NPI:1154768117
Name:ALMASMARY, IHTIRAM AHMED (MD)
Entity type:Individual
Prefix:MRS
First Name:IHTIRAM
Middle Name:AHMED
Last Name:ALMASMARY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:130 TOWN CENTER DR STE 203
Mailing Address - Street 2:BEAUMONT MEDICAL STAFF AFFAIRS
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1744
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15540 BEECH DALY RD
Practice Address - Street 2:BOTSFORD MEDICAL CENTER-REDFORD
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3804
Practice Address - Country:US
Practice Address - Phone:313-387-5253
Practice Address - Fax:313-387-5263
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2016-12-28
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Provider Licenses
StateLicense IDTaxonomies
MI4301103134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine