Healthcare Provider Details

I. General information

NPI: 1952925679
Provider Name (Legal Business Name): ABDULLAH MUHAMMAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 03/22/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N EAST AVENUE HENRY FORD ALLEGIANCE HEALTH
JACKSON MI
49201
US

IV. Provider business mailing address

205 N EAST AVENUE HENRY FORD ALLEGIANCE HEALTH
JACKSON MI
49201
US

V. Phone/Fax

Practice location:
  • Phone: 517-205-7147
  • Fax: 517-205-7050
Mailing address:
  • Phone: 517-205-7147
  • Fax: 517-205-7050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-50772
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: