Provider Demographics
NPI:1790104057
Name:RAFIQ, NAHEED (MD)
Entity Type:Individual
Prefix:
First Name:NAHEED
Middle Name:
Last Name:RAFIQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:517-366-5010
Mailing Address - Fax:517-366-5014
Practice Address - Street 1:3245 N ADRIAN HWY STE A
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221
Practice Address - Country:US
Practice Address - Phone:517-366-5010
Practice Address - Fax:517-366-5014
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35130968208000000X
390200000X
MI4301113569208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1790104057Medicaid
OH0127901Medicaid
MIM35150155OtherMEDICARE PIN