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NPI Code Detail

MEDICARE: JESSICA L. MULBAH PHARMD

MEDICARE: JESSICA L. MULBAH PHARMD
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
11835I0206XInfectious Diseases Pharmacist5302415382MI

General Provider Information

NPI Number : 1538006663
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA L. MULBAH PHARMD
Provider Business Mailing Address
First Line : 7430 2ND AVE APT 432
Second Line :
City : DETROIT
State : MI
Zip : 48202-2750
Country : US
Telephone Number : 770-572-9591
Fax Number :
Provider Business Practice Location Address
First Line : 6777 W MAPLE RD
Second Line :
City : WEST BLOOMFIELD
State : MI
Zip : 48322-3013
Country : US
Telephone Number : 248-325-3291
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2026
Last Update Date : 04/29/2026

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