Individual
DR. MOHAMMAD AL-HARASTANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1083 SUNCREST DR, SUITE-A, LAPEER, MI 48446-4421
(810) 245-9700
(810) 245-9703
Mailing address
1083 SUNCREST DR, SUITE-A, LAPEER, MI 48446-4421
(810) 245-9700
(810) 245-9703
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301067273
MI
2080A0000X
Pediatric Adolescent Medicine Physician
4301067273
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026494
HEALTH ADVANTAGE NETWORK
MI
05
—
1619968922
—
MI
01
—
305-044-1237-1
BLUE CARE NETWORK
MI
01
—
35-0-44-1237-1
BCBS
MI
01
—
350D410030
BLUE CARE NETWORK
MI
01
—
370011198
METRAHEALTH
MI
01
—
41A87114
HEALTH PLUS
MI
01
—
5243111
AETNA
MI
01
—
526
PPOM
MI
01
—
8572330001
CIGNA
MI
01
—
C3769
MCARE
MI
01
—
F76263
HEALTH ALLIANCE PLAN
MI
01
—
P48210001
MEDICARE PTAN
—
Enumeration date
11/04/2005
Last updated
02/05/2014
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