Provider Demographics
NPI:1700415163
Name:AHMED, FARAAZ (MD)
Entity type:Individual
Prefix:
First Name:FARAAZ
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CASS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48726-1076
Mailing Address - Country:US
Mailing Address - Phone:989-872-2410
Mailing Address - Fax:
Practice Address - Street 1:245 S RIDGE ST
Practice Address - Street 2:
Practice Address - City:PORT SANILAC
Practice Address - State:MI
Practice Address - Zip Code:48469-9704
Practice Address - Country:US
Practice Address - Phone:810-376-7000
Practice Address - Fax:810-376-4908
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301508380207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine