Healthcare Provider Details

I. General information

NPI: 1184534141
Provider Name (Legal Business Name): MUSTAFA A PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30260 CHERRY HILL RD
GARDEN CITY MI
48135-2676
US

IV. Provider business mailing address

30260 CHERRY HILL RD
GARDEN CITY MI
48135-2676
US

V. Phone/Fax

Practice location:
  • Phone: 734-469-2444
  • Fax:
Mailing address:
  • Phone: 734-469-2444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MUSTAFA ABDUL-HUSSEIN
Title or Position: MD
Credential:
Phone: 313-948-9721