Basic Information
| Provider Information | |||||||||
| NPI: | 1740216837 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MONROE HEALTH CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 N MACOMB | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481623083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7343842741 | ||||||||
| FaxNumber: | 7343842061 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 N MACOMB ST | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48162 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7343842741 | ||||||||
| FaxNumber: | 7343842061 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 11/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | HAQ | ||||||||
| AuthorizedOfficialFirstName: | IHSAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | INTERNAL MEDICINE | ||||||||
| AuthorizedOfficialTelephone: | 7343842741 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.