Provider Demographics
NPI:1790967206
Name:MIR M. ASGHAR MD PLC
Entity type:Organization
Organization Name:MIR M. ASGHAR MD PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ASGHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACR
Authorized Official - Phone:313-598-7460
Mailing Address - Street 1:1316 DACOSTA ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1427
Mailing Address - Country:US
Mailing Address - Phone:313-598-7460
Mailing Address - Fax:734-236-6030
Practice Address - Street 1:140 S INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-9493
Practice Address - Country:US
Practice Address - Phone:734-316-2268
Practice Address - Fax:734-316-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064278207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP16770001Medicare PIN