Provider Demographics
NPI:1609341254
Name:SYED TAJUDDIN MD PLLC
Entity Type:Organization
Organization Name:SYED TAJUDDIN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:TAJUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-249-7933
Mailing Address - Street 1:5321 BETHENY CIR
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48198-9653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24327 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1129
Practice Address - Country:US
Practice Address - Phone:313-525-4252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care