Provider Demographics
NPI:1861656746
Name:ASHRAF, AMBREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMBREEN
Middle Name:
Last Name:ASHRAF
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 1:1737 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2044
Mailing Address - Country:US
Mailing Address - Phone:208-891-9467
Mailing Address - Fax:734-721-0041
Practice Address - Street 1:6300 N HAGGERTY RD
Practice Address - Street 2:STE 210
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4472
Practice Address - Country:US
Practice Address - Phone:313-240-7595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301093080207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology