Active NPI
Mian Omar Iftikhar, M.D
- Internal Medicine Physician
- Pontiac, MI
National Provider Identifier
1861807604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301105336
- Practice address
- 44405 Woodward Ave
Pontiac, MI 48341-5023 - Phone
- (248) 858-6233
- NPI assigned
- Jun 30, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301105336 | MI | Primary |
Addresses
Primary practice location
44405 Woodward Ave
Pontiac, MI 48341-5023
Mailing address
900 Martin Luther King Jr Blvd S
Apt F-25
Pontiac, MI 48341-2900
Phone (347) 681-4937
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301105336 | MI | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404086400000",
"number": "1861807604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 MARTIN LUTHER KING JR BLVD S",
"address_2": "APT F-25",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412900",
"telephone_number": "347-681-4937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-6233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IFTIKHAR",
"first_name": "MIAN OMAR",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-30",
"last_updated": "2014-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301105336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.