Basic Information
Provider Information
NPI: 1720459555
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABDUL HAMEED
FirstName: ASIF
MiddleName: MOHAMMED
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 FORD PL STE 3A
Address2:  
City: DETROIT
State: MI
PostalCode: 482023450
CountryCode: US
TelephoneNumber: 3138744806
FaxNumber:  
Practice Location
Address1: 2799 W GRAND BLVD
Address2:  
City: DETROIT
State: MI
PostalCode: 482022608
CountryCode: US
TelephoneNumber: 8006536568
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/20/2015
LastUpdateDate: 09/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301506787MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001X4301506787MIN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200X4301506787MIY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


Home