Organization
MOSES MUZQUIZ JR, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOSES MUZQUIZ JR. M.D. (PRESIDENT/PHYSICIAN)
(517) 787-4111
Entity
Organization
Contact information
Practice address
1041 LAURENCE AVENUE, JACKSON, MI 49202
(517) 787-4111
(517) 782-8869
Mailing address
1041 LAURENCE AVENUE, JACKSON, MI 49202
(517) 787-4111
(517) 782-8869
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301026718
MI
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0420163
PHP
MI
01
—
060010955
RR MEDICARE
MI
01
—
060010955
RAILROAD MEDICARE
—
01
—
0603883572
BCBS
MI
01
—
0603883572
BLUE CROSS BLUE SHIELD
—
01
—
102860
PPOM
MI
05
—
1979265
—
MI
01
—
4904
GLHP
MI
01
—
4904
GREAT LAKES HEALTH PLAN
—
01
—
6305
HPM
MI
01
—
6305
HEALTH PLAN OF MICHIGAN
—
01
—
M012105
CHAMPUS
MI
01
—
M012105
CHAMPUS
—
01
—
P58363
BLUE CARE NETWORK
MI
Enumeration date
11/17/2009
Last updated
04/29/2010
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