Provider Demographics
NPI:1962123562
Name:FURIUM PULMONARY & CRITICAL CARE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:FURIUM PULMONARY & CRITICAL CARE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FURQAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDIQI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-655-7363
Mailing Address - Street 1:24005 NOBLE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2737
Mailing Address - Country:US
Mailing Address - Phone:316-655-7363
Mailing Address - Fax:
Practice Address - Street 1:27901 WOODWARD AVE STE 220
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-0918
Practice Address - Country:US
Practice Address - Phone:316-655-7363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301108555OtherSTATE LICENSE
MI1639481344Medicaid