Provider Demographics
NPI:1346414083
Name:MASROOR HAQ, MD, PLLC
Entity Type:Organization
Organization Name:MASROOR HAQ, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MASROOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-652-3310
Mailing Address - Street 1:950 W AVON RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2761
Mailing Address - Country:US
Mailing Address - Phone:248-652-3310
Mailing Address - Fax:248-652-6971
Practice Address - Street 1:950 W AVON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2761
Practice Address - Country:US
Practice Address - Phone:248-652-3310
Practice Address - Fax:248-652-6971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010602522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP15560002Medicare PIN