Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 4301054597 | MI |
NPI | 1457382939 |
---|---|
Provider Name | Mutee Husein Abdeljaber |
First Address | Caro, MI 48723-0330 |
Second Address | Caro, MI 48723-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 08/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
316227210 | (05) | MI |
F25001 | (02) |