Basic Information
| Provider Information | |||||||||
| NPI: | 1932123650 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IRFAN | ||||||||
| FirstName: | MOHAMMED | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 GREEN RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481051598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349953764 | ||||||||
| FaxNumber: | 2084759028 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 GREEN RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481051598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349953764 | ||||||||
| FaxNumber: | 2084759028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 07/17/2017 | ||||||||
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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 | 207P00000X | 4301084726 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 4301084726 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.