Basic Information
| Provider Information | |||||||||
| NPI: | 1124243282 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AFTAB | ||||||||
| FirstName: | MACKSOOD | ||||||||
| MiddleName: | AHMAD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3400 N CENTER RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486037920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897539000 | ||||||||
| FaxNumber: | 9897534024 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 N CENTER RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486037920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9897539000 | ||||||||
| FaxNumber: | 9897534024 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2007 | ||||||||
| LastUpdateDate: | 01/17/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | 5101015698 | MI | Y | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | 222051 | MA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.