Individual
MUSTAFIZUR CHOUDHURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
15621
ND
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
5101019831
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073877999
—
MI
01
—
5823530
BCBSM
MI
Enumeration date
06/25/2012
Last updated
04/14/2022
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