Provider Demographics
NPI:1134143654
Name:ADVANCED SLEEP NEURODIAGNOSTICS, PC
Entity Type:Organization
Organization Name:ADVANCED SLEEP NEURODIAGNOSTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:I
Authorized Official - Last Name:ZAHOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-442-3700
Mailing Address - Street 1:24001 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE #140
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2555
Mailing Address - Country:US
Mailing Address - Phone:248-442-3700
Mailing Address - Fax:248-442-8860
Practice Address - Street 1:24001 ORCHARD LAKE RD
Practice Address - Street 2:SUITE #140
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2555
Practice Address - Country:US
Practice Address - Phone:248-442-3700
Practice Address - Fax:248-442-8860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062300261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4570234Medicaid
MI0N92090Medicare PIN
MI4570234Medicaid
MIH92424Medicare UPIN