Provider Demographics
NPI:1457011124
Name:ASCENT REDICARE PLLC
Entity Type:Organization
Organization Name:ASCENT REDICARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ASGHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-598-7460
Mailing Address - Street 1:1255 E GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1721
Mailing Address - Country:US
Mailing Address - Phone:517-545-7400
Mailing Address - Fax:517-545-7477
Practice Address - Street 1:1255 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1721
Practice Address - Country:US
Practice Address - Phone:517-545-7400
Practice Address - Fax:517-545-7477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty