Individual
DR. MUDASSIR ALI DAIMEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4967 CROOKS RD, STE 130, TROY, MI 48098-5801
(248) 952-1601
(248) 952-0192
Mailing address
4967 CROOKS RD, STE 130, TROY, MI 48098-5801
(248) 952-1601
(248) 952-0192
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301076708
MI
208M00000X
Hospitalist Physician
4301076708
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205838307
NPI #
MI
05
—
4846342
—
MI
01
—
70-0-F32947-0
BCBS CPIN #
MI
01
—
MD076708
BCBSM
MI
Enumeration date
06/02/2005
Last updated
10/16/2007
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