Individual
ABU FAZAL SHAIK MOHAMMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28411 NORTHWESTERN HWY, SUITE 1050, SOUTHFIELD, MI 48034-5544
(248) 354-4709
(248) 354-4807
Mailing address
PO BOX 674147, DETROIT, MI 48267-4147
(248) 358-4892
(248) 358-5125
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301088545
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346398971
GRP NPI
MI
01
—
4301088545
LICENSE
MI
Enumeration date
12/19/2008
Last updated
06/29/2014
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