Organization
MUHAMMED R MIRZA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUHAMMED R MIRZA MD (OWNER)
(989) 846-3555
Entity
Organization
Contact information
Practice address
805 W CEDAR STREET, STANDISH, MI 48658
(989) 846-3555
(989) 846-3546
Mailing address
805 W CEDAR STREET, PO BOX 430, STANDISH, MI 48658
(989) 846-3555
(989) 846-3546
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301064585
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100647012
BLUE CROSS BLUE SHIELD MI
MI
01
—
1437156015
NPI INDIVIDUAL
MI
05
—
4224665
—
MI
01
—
4301064585
LICENSE NUMBER
MI
01
—
64R01184
HEALTH PLUS ID
MI
Enumeration date
03/27/2007
Last updated
08/22/2020
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