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NPI Code Detail

MEDICARE: MUTAZ MUATH ARAFAT ABU-LAILA MD

MEDICARE: MUTAZ MUATH ARAFAT ABU-LAILA MD
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
1390200000XStudent in an Organized Health Care Education/Training Program4351056839MI

General Provider Information

NPI Number : 1215863592
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUTAZ MUATH ARAFAT ABU-LAILA MD
Provider Business Mailing Address
First Line : 1675 LEAHY ST STE 315A
Second Line :
City : MUSKEGON
State : MI
Zip : 49442-5543
Country : US
Telephone Number : 231-672-1690
Fax Number : 231-672-6202
Provider Business Practice Location Address
First Line : 1150 E SHERMAN BLVD STE 1100
Second Line :
City : MUSKEGON
State : MI
Zip : 49444-4607
Country : US
Telephone Number : 231-672-1690
Fax Number : 231-672-6202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2026
Last Update Date : 06/23/2026

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