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General NPI Number Information
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NPI Number | 1508329137
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Entity Type | Individual
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Provider Name | BORA MUSTAFA AGABIGUM MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 30055 NORTHWESTERN HWY STE 101
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3260
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Country | US
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Telephone | 248-865-4444
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Fax | 248-865-6161
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Provider Business Mailing Address
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Address Line | 1072 SUGAR MAPLE CT
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City | FENTON
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State | MI
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Zip | 48430-9680
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Country | US
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Telephone | 810-931-6239
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Fax |
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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 | 207YX0901X
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Taxonomy Name | Otology & Neurotology Physician
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License Number | 4301511600
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4301511600
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License Number State | MI
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