Provider Demographics
NPI:1093156028
Name:MASOOD, ADEEL (MD)
Entity Type:Individual
Prefix:
First Name:ADEEL
Middle Name:
Last Name:MASOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44405 WOODWARD AVE
Mailing Address - Street 2:ST. JOSEPH MERCY OAKLAND, MEDICAL EDUCATION DEPTT.
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5023
Mailing Address - Country:US
Mailing Address - Phone:248-858-6233
Mailing Address - Fax:248-858-3244
Practice Address - Street 1:44405 WOODWARD AVE
Practice Address - Street 2:ST. JOSEPH MERCY OAKLAND, MEDICAL EDUCATION DEPTT.
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5023
Practice Address - Country:US
Practice Address - Phone:248-858-6233
Practice Address - Fax:248-858-3244
Is Sole Proprietor?:No
Enumeration Date:2013-07-05
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301102755207R00000X
MDD0080707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine