MEDICARE: DR. BHEKUMUSA MSIBI D.O.

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	208000000X	Pediatrics Physician	5101012162	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12-00182	OTHER	MI	PHYSICIANS HLTH PLAN
2	355370019	OTHER	MI	FED EMP PROG BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	P95344	OTHER	MI	BLUE CARE NETWORK
5	3553701064	OTHER	MI	BLUE CROSS BLUE SHIELD
6	1008811	OTHER	MI	MCLAREN HEALTH PLAN

General Provider Information

NPI Number	:	1649212952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHEKUMUSA MSIBI D.O.

Provider Business Mailing Address
First Line	:	1970 ASHLAND DR
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-1219
Country	:	US
Telephone Number	:	989-772-1500
Fax Number	:	989-772-9301

Provider Business Practice Location Address
First Line	:	1970 ASHLAND DR
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858-1219
Country	:	US
Telephone Number	:	989-772-1500
Fax Number	:	989-772-9301

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	09/26/2011

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Directions to “ DR. BHEKUMUSA MSIBI D.O.” Practice Location

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