Provider Demographics
NPI:1346693413
Name:MAZHAR, SYED MOHSIN MOHSIN (MD)
Entity type:Individual
Prefix:MR
First Name:SYED MOHSIN
Middle Name:MOHSIN
Last Name:MAZHAR
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38300 VAN DYKE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1122
Mailing Address - Country:US
Mailing Address - Phone:586-722-2865
Mailing Address - Fax:586-722-2754
Practice Address - Street 1:38300 VAN DYKE AVE STE 106
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1122
Practice Address - Country:US
Practice Address - Phone:586-722-2865
Practice Address - Fax:586-722-2754
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2025-05-06
Deactivation Date:2017-02-27
Deactivation Code:
Reactivation Date:2017-03-30
Provider Licenses
StateLicense IDTaxonomies
MI4301508173207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine