# HAZEL PARK MEDICAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265763973
- **Authorized official:** DR. MUSIB GAPPY M.D. (PRESIDENT)
- **Authorized official phone:** (248) 399-8331

## Contact information

- **Practice address:** 3161 HILTON RD, FERNDALE, MI 48220-1038
- **Practice address phone:** (248) 399-8331
- **Practice address fax:** (248) 399-3912
- **Mailing address:** 23411 JOHN R RD, HAZEL PARK, MI 48030-1404
- **Mailing address phone:** (248) 399-8331
- **Mailing address fax:** (248) 399-3912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 4301057989 | MI | Yes |

## Other

- **Enumeration date:** 01/20/2010
- **Last updated:** 07/13/2010