Provider Demographics
NPI:1659747475
Name:AHSAN, ARSALAN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ARSALAN
Middle Name:
Last Name:AHSAN
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36545 SAXONY RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3022
Mailing Address - Country:US
Mailing Address - Phone:313-878-6867
Mailing Address - Fax:
Practice Address - Street 1:36545 SAXONY RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48335-3022
Practice Address - Country:US
Practice Address - Phone:313-878-6867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-16
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant