Individual provider Active NPI

Mabrur Kamal Ahmed, DNP

  • Family Nurse Practitioner
  • Garden City, MI
National Provider Identifier
1780411603
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704313278 Issued in MI
Practice address
6255 Inkster Rd Ste 104
Garden City, MI 48135-2538
Phone
(248) 590-0202
Fax
(248) 590-0278
NPI assigned
Sep 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4704313278 MI
Family Nurse Practitioner 363LF0000X 4704313278 MI Primary

Addresses

Primary practice location

6255 Inkster Rd Ste 104
Garden City, MI 48135-2538

Mailing address

6255 Inkster Rd Ste 104
Garden City, MI 48135-2538
Phone (248) 590-0202

Other practice location 1

36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704313278MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Digestive Care, PC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1780411603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 INKSTER RD STE 104",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352538",
            "telephone_number": "248-590-0202",
            "fax_number": "248-590-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 INKSTER RD STE 104",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352538",
            "telephone_number": "248-590-0202",
            "fax_number": "248-590-0278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36475 Five Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481541971",
            "country_code": "US",
            "telephone_number": "734-655-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MABRUR",
        "middle_name": "KAMAL",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4704313278",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704313278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

Verify at the official NPI Registry.