Individual
DR. MUSTAPHA MOHAMED MALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1623 FORD AVE, WYANDOTTE, MI 48192-2303
(734) 389-7167
(734) 282-7390
Mailing address
29992 NORTHWESTERN HWY STE C, FARMINGTON HILLS, MI 48334-3292
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MI-4301081080
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104331557
—
MI
Enumeration date
05/18/2006
Last updated
10/26/2023
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