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Individual

IHSIN MOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5701 BOW POINTE DR STE 150, CLARKSTON, MI 48346-3198
(248) 922-6880
Mailing address
275 HOSPITAL PKWY, SAN JOSE, CA 95119-1106

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0024165531
VA
363L00000X
Nurse Practitioner
Primary
4704280593
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8955531
VA
Enumeration date
05/11/2006
Last updated
12/09/2025
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