Healthcare Provider Details

I. General information

NPI: 1649371071
Provider Name (Legal Business Name): MUHAMMAD ABDULLAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MUHAMMAD ABDULLAH M.D.

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N JACKSON ST
JACKSON MI
49201-1266
US

IV. Provider business mailing address

505 N JACKSON ST
JACKSON MI
49201-1266
US

V. Phone/Fax

Practice location:
  • Phone: 517-748-5500
  • Fax: 517-783-2728
Mailing address:
  • Phone: 517-748-5500
  • Fax: 517-783-2728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301104795
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0064911
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101239995
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: