Provider Demographics
NPI:1922096452
Name:ZAHOOR, MOHAMMED IDRIS (MD)
Entity Type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:IDRIS
Last Name:ZAHOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:24001 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336
Mailing Address - Country:US
Mailing Address - Phone:248-442-3700
Mailing Address - Fax:248-442-8860
Practice Address - Street 1:24001 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336
Practice Address - Country:US
Practice Address - Phone:248-442-3700
Practice Address - Fax:248-442-8860
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010623002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1015968OtherMCLAREN HEALTH PLAN
MI383520014OtherCOMMUNITY CHOICE OF MI
MI4676313Medicaid
MI383520014OtherTOTAL HEALTH CARE
MI4570234Medicaid
MI0631428OtherBCBSM
MI0P20610Medicare PIN
MI1015968OtherMCLAREN HEALTH PLAN
MIH92424Medicare UPIN
MIN92090001Medicare PIN