KEFAH ABBAS MAZLOUM NPI 1356093553

NPI Information

NPI: 1356093553
Provider Name: KEFAH ABBAS MAZLOUM
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2799 W GRAND BLVD
DETROIT, MI
ZIP 48202
Phone: (800) 653-6568
Get Directions

Kefah Abbas Mazloum is a family nurse practitioner in Detroit, MI with 2 years of experience. Kefah Abbas Mazloum NPI is 1356093553. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduation Year:2022

The provider's business location address is:

2799 W GRAND BLVD
DETROIT, MI
ZIP 48202-608
Phone: (800) 653-6568

The NPI 1356093553 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/19/2022 and was last updated on 4/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	F09220623	MICHIGAN	No
2	363LF0000X	Nurse Practitioner	Family	4704341497	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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