Provider Demographics
NPI:1659123313
Name:TAYAB, IQRA
Entity Type:Individual
Prefix:MRS
First Name:IQRA
Middle Name:
Last Name:TAYAB
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:IQRA
Other - Middle Name:
Other - Last Name:TAYAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IQRA TAYAB
Mailing Address - Street 1:1200 NAPA
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-7714
Mailing Address - Country:US
Mailing Address - Phone:734-772-5700
Mailing Address - Fax:
Practice Address - Street 1:1200 NAPA
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-7714
Practice Address - Country:US
Practice Address - Phone:734-772-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health