Basic Information
Provider Information
NPI: 1952925679
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUHAMMAD
FirstName: ABDULLAH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MBBS MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 205 N EAST AVENUE
Address2: HENRY FORD ALLEGIANCE HEALTH
City: JACKSON
State: MI
PostalCode: 49201
CountryCode: US
TelephoneNumber: 5172057147
FaxNumber: 5172057050
Practice Location
Address1: 205 N EAST AVENUE
Address2: HENRY FORD ALLEGIANCE HEALTH
City: JACKSON
State: MI
PostalCode: 49201
CountryCode: US
TelephoneNumber: 5172057147
FaxNumber: 5172057050
Other Information
ProviderEnumerationDate: 05/29/2020
LastUpdateDate: 01/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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