Basic Information
| Provider Information | |||||||||
| NPI: | 1407137375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMZA | ||||||||
| FirstName: | ASHRAF | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3154 LINDENWOOD DR | ||||||||
| Address2: | |||||||||
| City: | DEARBORN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481201314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175574181 | ||||||||
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| Practice Location | |||||||||
| Address1: | 18101 OAKWOOD BLVD | ||||||||
| Address2: | |||||||||
| City: | DEARBORN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3134362577 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2011 | ||||||||
| LastUpdateDate: | 05/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0002X | N | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care | 261QP2300X | N | Ambulatory Health Care Facilities | Clinic/Center | Primary Care | 282E00000X | N | Hospitals | Long Term Care Hospital | 282N00000X | 4301099664 | MI | N | Hospitals | General Acute Care Hospital | 207R00000X | 4301099664 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.