Provider Demographics
NPI:1861773491
Name:OMRAN, QASIM M (MD)
Entity type:Individual
Prefix:DR
First Name:QASIM
Middle Name:M
Last Name:OMRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:51140 SILVERTON
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-7719
Mailing Address - Country:US
Mailing Address - Phone:313-808-0602
Mailing Address - Fax:313-808-0602
Practice Address - Street 1:35700 WARREN RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3808
Practice Address - Country:US
Practice Address - Phone:734-742-5153
Practice Address - Fax:734-742-5145
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075275207RC0200X, 207RS0012X, 207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1427770338Medicaid