Individual
MUSTAFA MOHAMMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-1888
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-1888
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101026663
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2019
Last updated
06/20/2022
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