MEDICARE: DR. MUSTAFA GULAMABBAS BOXWALA M.D.

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	207RH0003X	Hematology & Oncology Physician	4301049215	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548260128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUSTAFA GULAMABBAS BOXWALA M.D.

Provider Business Mailing Address
First Line	:	3577 W 13 MILE RD
Second Line	:	SUITE 103
City	:	ROYAL OAK
State	:	MI
Zip	:	48073-6710
Country	:	US
Telephone Number	:	248-288-4500
Fax Number	:	248-288-0450

Provider Business Practice Location Address
First Line	:	34743 HUNTINGTON COURT
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-6710
Country	:	US
Telephone Number	:	248-794-3759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	08/01/2019

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