Provider Demographics
NPI:1801399365
Name:ALSHWAF, MHD IYAD (MD)
Entity Type:Individual
Prefix:
First Name:MHD IYAD
Middle Name:
Last Name:ALSHWAF
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 1:4052 LEGACY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4285
Mailing Address - Country:US
Mailing Address - Phone:517-272-9700
Mailing Address - Fax:
Practice Address - Street 1:4052 LEGACY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4285
Practice Address - Country:US
Practice Address - Phone:517-272-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075752207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology