Provider Demographics
NPI:1790545390
Name:PARK PLAZA MD PC
Entity Type:Organization
Organization Name:PARK PLAZA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARIF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-234-1651
Mailing Address - Street 1:G1071 N BALLENGER HWY STE 206
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-4453
Mailing Address - Country:US
Mailing Address - Phone:810-234-1651
Mailing Address - Fax:810-600-3043
Practice Address - Street 1:G1071 N BALLENGER HWY STE 206
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-4453
Practice Address - Country:US
Practice Address - Phone:810-234-1651
Practice Address - Fax:810-600-3043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty