Organization
PREMIER BEHAVIORAL MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASROOR UL HAQ MD (PSYCHIATRIST)
(248) 719-1256
Entity
Organization
Contact information
Practice address
20282 MIDDLEBELT RD, LIVONIA, MI 48152-2002
(248) 536-2028
(248) 536-2451
Mailing address
20282 MIDDLEBELT RD, LIVONIA, MI 48152-2002
(248) 536-2028
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301060252
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301060252
STATE LICENSE
MI
01
—
4301083821
STATE LICENSE
MI
Enumeration date
11/17/2015
Last updated
12/09/2015
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