Provider Demographics
NPI:1396085817
Name:IQBAL, ADEL MUZAFFAR (DPT)
Entity type:Individual
Prefix:
First Name:ADEL
Middle Name:MUZAFFAR
Last Name:IQBAL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 NORTHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48198-8704
Mailing Address - Country:US
Mailing Address - Phone:313-737-0832
Mailing Address - Fax:
Practice Address - Street 1:26000 5 MILE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3236
Practice Address - Country:US
Practice Address - Phone:313-387-4430
Practice Address - Fax:313-387-4010
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist