| Organization Name: | HAMTRAMCK GENERAL MEDICAL PRACTICE PLLC |
| NPI Number: | 1295074409 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MOTAHAR H AHMED (OWNER) |
| Mailing Address: | 9632 Conant St Hamtramck |
| State: | MI US |
| Postal Code: | 482123305 |
| Phone Number: | 3138711912 |
| Fax Number: | 3138711914 |
| NPI Enumeration Date: | 02/07/2013 |
| NPI Last Update Date: | 02/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 4301089057 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |