Individual
MAZHAR MUNIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(800) 968-6866
Mailing address
PO BOX 1969, GRAND RAPIDS, MI 49501-1969
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301037699
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3349549
—
MI
01
—
MM037699
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/14/2005
Last updated
04/21/2022
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