Provider Demographics
NPI:1659756005
Name:ASLAM, HASEEB (MD)
Entity Type:Individual
Prefix:
First Name:HASEEB
Middle Name:
Last Name:ASLAM
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 1:16500 N PARK DR APT 914
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4753
Mailing Address - Country:US
Mailing Address - Phone:313-327-7034
Mailing Address - Fax:
Practice Address - Street 1:16001 WEST NILE MILE ROAD FISHER CENTER
Practice Address - Street 2:401
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-849-3151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107879207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine