Provider Demographics
NPI:1912949645
Name:MERCHANT, NASREEN (MD)
Entity Type:Individual
Prefix:
First Name:NASREEN
Middle Name:
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:23133 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-3268
Mailing Address - Country:US
Mailing Address - Phone:248-477-0100
Mailing Address - Fax:248-477-6153
Practice Address - Street 1:23133 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-3268
Practice Address - Country:US
Practice Address - Phone:248-477-0100
Practice Address - Fax:248-477-6153
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301052988208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIC7096OtherMCARE
MIP76422OtherBLUE CROSS
MI4573545OtherAETNA
MI139951OtherCARE CHOICES
MI4144840Medicaid
MI4144850Medicaid
MI633369OtherBLUE CROSS
MI3506333691OtherBLUE CROSS
MI4144840Medicaid
MIP76422OtherBLUE CROSS