Provider Demographics
NPI:1437156015
Name:MIRZA, MUHAMMED RASHID (MD)
Entity type:Individual
Prefix:DR
First Name:MUHAMMED
Middle Name:RASHID
Last Name:MIRZA
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:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:MI
Mailing Address - Zip Code:48658-0430
Mailing Address - Country:US
Mailing Address - Phone:989-846-3555
Mailing Address - Fax:989-846-3546
Practice Address - Street 1:805 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:MI
Practice Address - Zip Code:48658-9526
Practice Address - Country:US
Practice Address - Phone:989-846-3555
Practice Address - Fax:989-846-3546
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064585207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4224665Medicaid
MI0100647012OtherBCBSM
MI64RO1184OtherHEALTH PLUS
MION13050Medicare PIN
MI0100647012OtherBCBSM