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Individual

MUJTABA HUSAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
HUTZEL HOSPITAL PATHOLOGY, 4707 ST ANTOINE, DETROIT, MI 48201
(313) 993-2666
Mailing address
3800 WOODWARD AVE, SUITE 600, DETROIT, MI 48201-2061

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301033796
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0H22832
BCBSM GROUP #
MI
01
0H26083
BCBSM GROUP #
MI
Enumeration date
06/02/2006
Last updated
07/08/2007
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