Individual
NADEEM ULLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 SUMMIT AVE STE B, JACKSON, MI 49201-2465
(517) 768-1225
(517) 768-1250
Mailing address
200 SUMMIT AVE STE B, JACKSON, MI 49201-2465
(517) 768-1225
(517) 768-1250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301068267
MI
207RG0100X
Gastroenterology Physician
Primary
4301068267
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003811331
BCBS PIN
MI
05
—
104843618
—
MI
05
—
104859930
—
MI
05
—
1477592996
—
MI
01
—
158148
GREAT LAKES
MI
01
—
7802771
AETNA
MI
01
—
P00304763
RR MEDICARE
MI
01
—
P00328380
RR MEDICARE
MI
01
—
P00815449
RAILROAD MEDICARE
MI
Enumeration date
06/06/2006
Last updated
11/10/2025
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