Organization
DETROIT MEDICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAZMUL HAQUE M.D. (OWNER)
(248) 203-1282
Entity
Organization
Contact information
Practice address
14071 E SEVEN MILE RD, DETROIT, MI 48205
(313) 371-2828
(313) 371-9120
Mailing address
14071 E 7 MILE RD STE 106, DETROIT, MI 48205-2335
(248) 203-1282
(248) 203-4148
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301061429
MI
208000000X
Pediatrics Physician
4301086498
MI
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104670365
—
MI
Enumeration date
09/20/2006
Last updated
05/24/2021
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