| Mustafa S Bohra Md Plc | |
|
15120 Michigan Ave Dearborn MI 48126-2916 | |
| (313) 582-2142 | |
| (313) 582-8627 |
| Full Name | Mustafa S Bohra Md Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 15120 Michigan Ave, Dearborn, Michigan |
| Authorized Official Name and Position | Mustafa S Bohra (OWNER) |
| Authorized Official Contact | 3135822142 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mustafa S Bohra Md Plc 6950 Carlyle Crossing West Bloomfield MI 48322-3082 Ph: (313) 582-2142 | Mustafa S Bohra Md Plc 15120 Michigan Ave Dearborn MI 48126-2916 Ph: (313) 582-2142 |
| NPI Number | 1922199850 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 06/24/2008 |
| Medicare PECOS PAC ID | 4486544079 |
|---|---|
| Medicare Enrollment ID | O20040317001128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922199850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Mustafa S Bohra |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588651897 PECOS PAC ID: 7810887411 Enrollment ID: I20040320000700 |
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