Provider Demographics
NPI:1730190596
Name:NEPHROLOGY & INTERNAL MEDICINE PC
Entity type:Organization
Organization Name:NEPHROLOGY & INTERNAL MEDICINE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-238-4172
Mailing Address - Street 1:G3404 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1238
Mailing Address - Country:US
Mailing Address - Phone:810-238-4172
Mailing Address - Fax:810-238-4153
Practice Address - Street 1:G3404 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1238
Practice Address - Country:US
Practice Address - Phone:810-238-4172
Practice Address - Fax:810-238-4153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B56048Medicare PIN