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General NPI Number Information
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NPI Number | 1851457287
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Entity Type | Individual
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Provider Name | MUSHTAQUE ALI SYED MD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 4800 CLINTONVILLE RD
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City | CLARKSTON
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State | MI
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Zip | 48346-4297
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Country | US
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Telephone | 248-674-0903
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Fax | 248-674-3431
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Provider Business Mailing Address
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Address Line | 947 BALDWIN DR
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City | TROY
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State | MI
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Zip | 48098-5625
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Country | US
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Telephone | 248-879-9230
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Fax | 248-248-6743
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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 | 4301055989
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | MS155989
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License Number State | MI
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