| Mohammed Mushtaq Ahmed Hakim, | |
|
205 N East Ave, Jackson, MI 49201-1753 | |
| (517) 205-7836 | |
| Not Available |
| Full Name | Mohammed Mushtaq Ahmed Hakim |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology - Pain Medicine |
| Location | 205 N East Ave, Jackson, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275152159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 4301514464 (Michigan) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 4301514464 (Michigan) | Primary |
| Entity Name | Henry Ford Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003989690 PECOS PAC ID: 0547178311 Enrollment ID: O20031111000300 |
| Entity Name | W.a. Foote Memorial Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760437826 PECOS PAC ID: 0244136067 Enrollment ID: O20031212000691 |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammed Mushtaq Ahmed Hakim, 451 E Town St Apt 209, Columbus, OH 43215-4724 Ph: (614) 680-2552 | Mohammed Mushtaq Ahmed Hakim, 205 N East Ave, Jackson, MI 49201-1753 Ph: (517) 205-7836 |
Dr. Melinda Mitchell, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-7836 | |
Clemon Pardales, D.O. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2775 Blake Rd, Jackson, MI 49201 Phone: 517-787-2906 Fax: 517-787-3039 | |
Dr. Vinay Anad-raj Pallekonda, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 255 W Michigan Ave, Jackson, MI 49201 Phone: 517-787-6440 Fax: 517-787-7230 | |
Dr. Daniel Robert Grutter, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 205 North East Ave, Anesthesia Department, Jackson, MI 49201 Phone: 517-205-3240 | |
Dr. Yung I Park, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 255 W Michigan Ave, Jackson, MI 49201 Phone: 517-787-6440 Fax: 517-787-4146 | |
Nicole M Horning, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 | |
Doris P Cralle, M.D Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 744 W Michigan Ave, Jackson, MI 49201 Phone: 517-787-6440 Fax: 517-787-4146 |