Basic Information
Provider Information
NPI: 1871974592
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHMED
FirstName: SANA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 21833 SHEFFIELD DR
Address2:  
City: FARMINGTON HILLS
State: MI
PostalCode: 483355494
CountryCode: US
TelephoneNumber: 2487074185
FaxNumber:  
Practice Location
Address1: 1 GENESYS PKWY
Address2:  
City: GRAND BLANC
State: MI
PostalCode: 484398065
CountryCode: US
TelephoneNumber: 8106065000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/18/2015
LastUpdateDate: 06/18/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X4301108143MIY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home