MEDICARE: MICHIGAN MEDICAL SERVICES PLLC

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
1	207R00000X	Internal Medicine Physician	4301052435	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	DE7851	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110H231730	OTHER	MI	BCBS
2	E77778	OTHER	MI	HAP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	029575	OTHER	MI	MIDWEST HEALTH PLAN
5	7761	OTHER	MI	TOTAL HEALTH CARE
6	C7669	OTHER	MI	MCARE
8	131038	OTHER	MI	CARE CHOICES

General Provider Information

NPI Number	:	1033154216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIGAN MEDICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	PO BOX 150
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-0150
Country	:	US
Telephone Number	:	248-265-4080
Fax Number	:	248-265-4082

Provider Business Practice Location Address
First Line	:	13530 MICHIGAN AVE
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-3574
Country	:	US
Telephone Number	:	313-945-0075
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SALEH MUSLAH
Credential	:	M.D.
Telephone Number	:	248-265-4080

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	03/06/2008

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