Individual
DR. MUHAMMAD ALI EHTESHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
29275 W 10 MILE RD, FARMINGTON HILLS, MI 48336-2817
(248) 350-2722
(248) 350-0154
Mailing address
29275 W 10 MILE RD, FARMINGTON HILLS, MI 48336-2817
(248) 350-2722
(248) 350-0154
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301072332
MI
207RP1001X
Pulmonary Disease Physician
Primary
4301072332
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F37521
BLUE CROSS BLUE SHIELD
MI
05
—
4770496
—
MI
Enumeration date
07/06/2006
Last updated
09/19/2012
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