Basic Information
| Provider Information | |||||||||
| NPI: | 1801154687 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NAQVI | ||||||||
| FirstName: | MARIAM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 49650 CHERRY HILL RD STE 230 | ||||||||
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| City: | CANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481874860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344953725 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9368 N LILLEY RD | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481704610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344163900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2012 | ||||||||
| LastUpdateDate: | 01/13/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501015880 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.