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Organization
PHYSICIAN GROUP
Active
Organization
PHYSICIAN GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AISHA ASHFAQ (OWNER)
(734) 444-4063
Entity
Organization
Contact information
Practice address
4870 W CLARK RD, STE 100A, YPSILANTI, MI 48197-1104
(734) 444-4063
(734) 418-2774
Mailing address
4870 W CLARK RD, STE 100 A, YPSILANTI, MI 48197-1104
(734) 444-4063
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/25/2010
Last updated
10/11/2012
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