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NPI Code Detail

MEDICARE: MUKSI, LLC

MEDICARE: MUKSI, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician4301061568MI

General Provider Information

NPI Number : 1003084492
Entity Type Code : Organization
Provider Name (Legal Business Name) : MUKSI, LLC
Provider Business Mailing Address
First Line : 3404 WARWICK DR
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-4707
Country : US
Telephone Number : 734-462-0340
Fax Number : 734-462-0344
Provider Business Practice Location Address
First Line : 26411 SOUTHFIELD RD
Second Line :
City : LATHRUP VILLAGE
State : MI
Zip : 48076-4528
Country : US
Telephone Number : 248-552-8195
Fax Number : 248-552-8537
Authorized Official
Title or Position : SOLE MEMBER
Name : MUNZER SAMAD
Credential : MD
Telephone Number : 248-935-7976
Provider Enumeration Date : 02/19/2008
Last Update Date : 11/05/2024

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Directions to “MUKSI, LLC ” Practice Location

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