Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 4301031338 | MI |
NPI | 1023095296 |
---|---|
Provider Name | Dr. Zaheda Shafqat Ali |
First Address | Ypsilanti, MI 48198-5662 |
Second Address | Ypsilanti, MI 48198-5662 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0108103562 | BCBS OF MI (01) | MI |
0800621 | TRAVELERS (01) | MI |
1731636 | (05) | MI |
F18654 | (02) |