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General NPI Number Information
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NPI Number | 1861007106
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Entity Type | Organization
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Legal Business Name | DR. WASFEH MUSHEINESH, P.C.
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 2117 SPRINGWELLS ST
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City | DETROIT
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State | MI
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Zip | 48209-1507
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Country | US
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Telephone | 313-409-1441
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Fax |
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Provider Business Mailing Address
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Address Line | 2117 SPRINGWELLS ST
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City | DETROIT
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State | MI
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Zip | 48209-1507
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Country | US
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Telephone | 313-409-1441
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/HEALTH CARE PROVIDER
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Name | WASFEH MUSHEINESH
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Credential | M.D.
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Telephone | 313-409-1441
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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