Organization
HAZEL PARK MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUSIB GAPPY M.D. (PRESIDENT)
(248) 399-8331
Entity
Organization
Contact information
Practice address
3161 HILTON RD, FERNDALE, MI 48220-1038
(248) 399-8331
(248) 399-3912
Mailing address
23411 JOHN R RD, HAZEL PARK, MI 48030-1404
(248) 399-8331
(248) 399-3912
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301057989
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F38756
BCBSM
MI
Enumeration date
01/20/2010
Last updated
07/13/2010
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