Provider Demographics
NPI:1831125467
Name:AGHA, ABID H (MD)
Entity Type:Individual
Prefix:DR
First Name:ABID
Middle Name:H
Last Name:AGHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5065 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1037
Mailing Address - Country:US
Mailing Address - Phone:810-230-0338
Mailing Address - Fax:810-715-5005
Practice Address - Street 1:4150 225TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:REED CITY
Practice Address - State:MI
Practice Address - Zip Code:49677-7910
Practice Address - Country:US
Practice Address - Phone:231-832-5821
Practice Address - Fax:231-388-1619
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010827592081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104586145Medicaid
MIH42269Medicare UPIN
MION85680Medicare ID - Type Unspecified