Individual
MUSTAFA AL-SHAMMARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
1701 W CHARLESTON BLVD STE 110, LAS VEGAS, NV 89102-2319
(702) 671-2391
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17199
NV
207RG0100X
Gastroenterology Physician
Primary
4301504577
MI
390200000X
Student in an Organized Health Care Education/Training Program
P29238
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205275161
—
NV
Enumeration date
06/24/2013
Last updated
05/18/2021
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