Provider Demographics
NPI:1164620175
Name:M A HAROON, MD, PC
Entity Type:Organization
Organization Name:M A HAROON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANZOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HAROON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-946-7200
Mailing Address - Street 1:24887 GODDARD RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3930
Mailing Address - Country:US
Mailing Address - Phone:734-946-7200
Mailing Address - Fax:734-946-5551
Practice Address - Street 1:24887 GODDARD RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3930
Practice Address - Country:US
Practice Address - Phone:734-946-7200
Practice Address - Fax:734-946-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301036971207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty