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Individual

TARIQ M AWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
30055 NORTHWESTERN HWY STE L-30, FARMINGTON HILLS, MI 48334-3211
(248) 865-4238
(248) 865-4237
Mailing address
PO BOX 2253, PHOENIX, AZ 85002-2253
(602) 606-8949

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
009931
AZ
207Q00000X
Family Medicine Physician
5101015599
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
009931
AZ
207QS0010X
Sports Medicine (Family Medicine) Physician
5101015599
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
OS17051
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009931
ARIZONA LICENSE
AZ
05
161081
AZ
01
5101015599
MICHIGAN LICENSE
MI
Enumeration date
05/12/2006
Last updated
11/26/2022
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