MEDICARE: MUTEE HUSEIN ABDELJABER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	4301054597	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457382939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUTEE HUSEIN ABDELJABER MD

Provider Business Mailing Address
First Line	:	PO BOX 330
Second Line	:	634 N STATE ST
City	:	CARO
State	:	MI
Zip	:	48723-0330
Country	:	US
Telephone Number	:	989-672-0092
Fax Number	:	989-672-0093

Provider Business Practice Location Address
First Line	:	634 N STATE ST
Second Line	:
City	:	CARO
State	:	MI
Zip	:	48723-1544
Country	:	US
Telephone Number	:	989-672-0092
Fax Number	:	989-672-0093

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	11/08/2011

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