Individual
AHMAD FAWAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2241 ATLAS DR, TROY, MI 48083-2452
(248) 835-5022
Mailing address
PO BOX 638257, CINCINNATI, OH 45263-8257
(888) 952-6772
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
4707317809
MI
363LF0000X
Family Nurse Practitioner
4704296870
MI
Other
Enumeration date
07/23/2015
Last updated
07/22/2025
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