| Organization Name: | PHYSICIAN GROUP |
| NPI Number: | 1740509116 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AISHA ASHFAQ (OWNER) |
| Mailing Address: | 4870 W Clark Rd Ste 100a Ypsilanti |
| State: | MI US |
| Postal Code: | 481971104 |
| Phone Number: | 7344444063 |
| Fax Number: | 7344182774 |
| NPI Enumeration Date: | 05/25/2010 |
| NPI Last Update Date: | 10/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |