MEDICARE: JFMM CORPORATION

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	207R00000X	Internal Medicine Physician	4301050453	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	:	1720302565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JFMM CORPORATION

Provider Business Mailing Address
First Line	:	9433 JOSEPH CAMPAU ST
Second Line	:
City	:	HAMTRAMCK
State	:	MI
Zip	:	48212-3435
Country	:	US
Telephone Number	:	313-872-0398
Fax Number	:	313-872-0533

Provider Business Practice Location Address
First Line	:	9433 JOSEPH CAMPAU ST
Second Line	:
City	:	HAMTRAMCK
State	:	MI
Zip	:	48212-3435
Country	:	US
Telephone Number	:	313-872-0398
Fax Number	:	313-872-0533

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. MAIMOONA HUSAIN
Credential	:	MD
Telephone Number	:	313-872-0398

Provider Enumeration Date	:	03/23/2010
Last Update Date	:	03/23/2010

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Directions to “JFMM CORPORATION ” Practice Location

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