Provider Demographics
NPI:1235177718
Name:CANCER & TRANSPLANT CONSULTANTS PLC
Entity Type:Organization
Organization Name:CANCER & TRANSPLANT CONSULTANTS PLC
Other - Org Name:MOMIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FEROZE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-388-6299
Mailing Address - Street 1:7105 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2009
Mailing Address - Country:US
Mailing Address - Phone:313-388-6299
Mailing Address - Fax:313-388-6328
Practice Address - Street 1:2021 MONROE ST STE 203
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2926
Practice Address - Country:US
Practice Address - Phone:313-388-6299
Practice Address - Fax:313-388-6328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301051771207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1396728507Medicaid
MI110E002110OtherBCBS
MI110E002110OtherBCN
MI0N32320Medicare PIN