NPIMap

Individual provider Active NPI

MD Wahiduzzaman, MD

  • Infectious Disease Physician
  • Warren, MI
National Provider Identifier
1598774564
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301072692 Issued in MI
Practice address
11900 East Twelve Mile Road
Suite 105
Warren, MI 48093
Phone
(586) 573-5143
Fax
(586) 573-5525
NPI assigned
Aug 7, 2006
Last updated
Aug 30, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301072692 MI
Infectious Disease Physician 207RI0200X 4301072692 MI Primary

Addresses

Primary practice location

11900 East Twelve Mile Road
Suite 105
Warren, MI 48093

Mailing address

11900 East Twelve Mile Road
Suite 105
Warren, MI 48093
Phone (586) 573-5143

Other identifiers 1

IdentifierTypeStateIssuer
4499470MedicaidMI

Other names 1

  • MD Wahid Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040604000272 MI Practitioner - Infectious Disease 0840272696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (586) 573-5143

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
56.06 of 100Reported as individual
Quality
62.57
Improvement activities
0
Cost
70.1

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301072692MIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamtramck Community Medical Center PC PastSince Jul 24, 2022 Accepting new patients
Hamtramck Community Medical Center PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mwahiduzzaman940758@direct.hfhs.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1598774564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 EAST TWELVE MILE ROAD",
            "address_2": "SUITE 105",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-5143",
            "fax_number": "586-573-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 EAST TWELVE MILE ROAD",
            "address_2": "SUITE 105",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-5143",
            "fax_number": "586-573-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHIDUZZAMAN",
        "first_name": "MD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301072692",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301072692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4499470",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MD",
            "last_name": "WAHID",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.