Individual
DR. AHMED E. EZZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
28595 ORCHARD LAKE RD, #110, FARMINGTON HILLS, MI 48334-2977
(248) 553-0606
(248) 553-7674
Mailing address
2234 COLONIAL BLVD, PAYER CONTRACTING & RELATIONS DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4301060864
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101715
CARE CHOICES HMO PROV. #
MI
01
—
300041558
RAILROAD MEDICARE
MI
05
—
3057642
—
MA
05
—
4711299
—
MI
Enumeration date
10/03/2005
Last updated
07/13/2012
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