Provider Demographics
NPI:1336443837
Name:MAZEN S AFRAM M.D.P.C.
Entity Type:Organization
Organization Name:MAZEN S AFRAM M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAZEN
Authorized Official - Middle Name:SAMI
Authorized Official - Last Name:AFRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-650-4738
Mailing Address - Street 1:1135 W UNIVERSITY DR
Mailing Address - Street 2:STE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1871
Mailing Address - Country:US
Mailing Address - Phone:248-650-4738
Mailing Address - Fax:248-650-4976
Practice Address - Street 1:1135 W UNIVERSITY DR
Practice Address - Street 2:STE 300
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1871
Practice Address - Country:US
Practice Address - Phone:248-650-4738
Practice Address - Fax:248-650-4976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072402207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N56310Medicare UPIN