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General NPI Number Information
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NPI Number | 1295758415
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Entity Type | Individual
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Provider Name | MUHAMMAD WASIULLAH MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 14551 SOUTHFIELD RD STE 1
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City | ALLEN PARK
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State | MI
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Zip | 48101-2687
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Country | US
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Telephone | 313-299-3420
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Fax | 313-299-3430
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Provider Business Mailing Address
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Address Line | P.O.BOX#238
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City | TAYLOR
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State | MI
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Zip | 48180-0238
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Country | US
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Telephone | 313-299-3420
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Fax | 313-299-3430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301069289
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License Number State | MI
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