Organization
AHMAD KADDURAH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMAD KASIM KADDURAH MD (OWNER)
(810) 233-7103
Entity
Organization
Contact information
Practice address
1 HURLEY PLZ, FLINT, MI 48503-5902
(810) 257-9000
Mailing address
PO BOX 956, GRAND BLANC, MI 48480-0956
(810) 233-7103
(810) 233-9710
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301063683
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104612989
—
MI
Enumeration date
02/26/2008
Last updated
01/10/2012
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