Provider Demographics
NPI:1619102134
Name:MURSHED, NAWAF H (MD)
Entity Type:Individual
Prefix:
First Name:NAWAF
Middle Name:H
Last Name:MURSHED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-0086
Mailing Address - Country:US
Mailing Address - Phone:734-374-1112
Mailing Address - Fax:734-374-1119
Practice Address - Street 1:11780 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-6862
Practice Address - Country:US
Practice Address - Phone:734-374-1112
Practice Address - Fax:734-374-1119
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010932122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI7264002OtherMEDICARE LOCALITY 99
MIMI7263002Medicare PIN