Basic Information
| Provider Information | |||||||||
| NPI: | 1821330473 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABDULMUNEM | ||||||||
| FirstName: | YASIR | ||||||||
| MiddleName: | AZHAR | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FORD PL | ||||||||
| Address2: | STE 2E | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482023450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3138744316 | ||||||||
| FaxNumber: | 3138761305 | ||||||||
| Practice Location | |||||||||
| Address1: | 2799 W GRAND BLVD | ||||||||
| Address2: | HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482022608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139162600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2013 | ||||||||
| LastUpdateDate: | 01/08/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 35.128365 | OH | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 4301103013 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 35.128365 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.