Provider Demographics
NPI:1992750723
Name:MUGHAL, MAJID M (MD)
Entity type:Individual
Prefix:
First Name:MAJID
Middle Name:M
Last Name:MUGHAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 HAMPTON PL
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3691
Mailing Address - Country:US
Mailing Address - Phone:517-347-3000
Mailing Address - Fax:517-347-8393
Practice Address - Street 1:2134 HAMPTON PL
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3691
Practice Address - Country:US
Practice Address - Phone:517-347-3000
Practice Address - Fax:517-347-8393
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26452207RP1001X
MI4301093925207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009940258Medicaid
MS09154767Medicaid
AL51538087OtherBLUE CROSS
AL009934011Medicaid
AL51530959OtherBLUE CROSS
AL009934018Medicaid
AL48-00186OtherUNITED HEALTH CARE
AL51530960OtherBLUE CROSS
AL009934019Medicaid
AL51530961OtherBLUE CROSS
AL51530960OtherBLUE CROSS
I42526Medicare UPIN
AL009934011Medicaid