Individual
MOHAMMAD MUSTAQUIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 661-6417
(248) 661-7390
Mailing address
140 HADSELL DR, BLOOMFIELD TOWNSHIP, MI 48302-0408
(248) 943-6895
(248) 661-7390
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601003917
MI
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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