Provider Demographics
NPI:1073544912
Name:M.A.MUNIR MD PC
Entity Type:Organization
Organization Name:M.A.MUNIR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:ASIM
Authorized Official - Last Name:MUNIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-366-5500
Mailing Address - Street 1:11400 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3041
Mailing Address - Country:US
Mailing Address - Phone:313-366-5500
Mailing Address - Fax:313-366-5505
Practice Address - Street 1:11400 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3041
Practice Address - Country:US
Practice Address - Phone:313-366-5500
Practice Address - Fax:313-366-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068351207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110H232350OtherBC GROUP
MI110H232350OtherBCN
MI030195OtherMIDWEST HEALTH PLAN
MI4891580Medicaid
MI4974262Medicaid
MIDG7462OtherRAILROAD MEDICARE GROUP
MI1073544912Medicaid
MI1108261692OtherBCBS BCN
MI5211840Medicaid
MI110H232350OtherBC GROUP
MI4974262Medicaid