Individual
MUTIU O BALOGUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1525 UNIVERSITY DR, AUBURN HILLS, MI 48326-2673
(313) 434-2315
Mailing address
700 CALVERT ST, DETROIT, MI 48202-1200
(313) 434-2315
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704334959
MI
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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