Organization Active NPI

M Hazem Raslan MD PC

  • Pulmonary Disease Physician
  • Canton, MI
National Provider Identifier
1306990676
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MR057633 Issued in MI
Legal business name
M HAZEM RASLAN MD PC
Practice address
6300 N Haggerty Rd
Suite 210
Canton, MI 48187-3568
Phone
(734) 641-3000
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mohamad Hazem Raslan, M.DNPI 1619938768
Title
Owner
Phone
(734) 641-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X MR057633 MI Primary

Addresses

Primary practice location

6300 N Haggerty Rd
Suite 210
Canton, MI 48187-3568

Mailing address

PO Box 253044
W. Bloomfield, MI 48325-3044
Phone (734) 641-3000

Other identifiers 2

IdentifierTypeStateIssuer
4579131MedicaidMI
DB4794OtherMIMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407001071 MI Part B Supplier - Clinic/Group Practice 9638162332 Receives reassigned benefits from 5 practitioners
Practice locations: Canton, MI; Gibraltar, MI

National Provider Directory

National Provider Directory

Locations

6300 N Haggerty Rd
Ste 210
Canton, MI 48187
Phone (734) 224-8240

19850 Middle Gibraltar Rd
Gibraltar, MI 48173
Phone (734) 346-0151

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1306990676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 253044",
            "city": "W. BLOOMFIELD",
            "state": "MI",
            "postal_code": "483253044",
            "telephone_number": "734-641-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N HAGGERTY RD",
            "address_2": "SUITE 210",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873568",
            "telephone_number": "734-641-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M HAZEM RASLAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "RASLAN",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "HAZEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-641-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "MR057633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4579131",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DB4794",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.