Provider Demographics
NPI:1073826293
Name:RUBINA AHMED, M.D., P.C.
Entity Type:Organization
Organization Name:RUBINA AHMED, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-718-7676
Mailing Address - Street 1:12701 TELEGRAPH RD
Mailing Address - Street 2:105
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-6847
Mailing Address - Country:US
Mailing Address - Phone:734-287-0700
Mailing Address - Fax:
Practice Address - Street 1:12701 TELEGRAPH RD
Practice Address - Street 2:105
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-6847
Practice Address - Country:US
Practice Address - Phone:734-287-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:M.D.P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI071462173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI449055410Medicaid