Individual provider Active NPI

Mussa Dib Mustapha, PHARM.D.

  • Pharmacist
  • Dearborn, MI
National Provider Identifier
1124385679
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302038283 Issued in MI
Practice address
7621 Chase Rd
Dearborn, MI 48126-1001
Phone
(313) 584-7621
NPI assigned
Apr 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302038283 MI Primary

Addresses

Primary practice location

7621 Chase Rd
Dearborn, MI 48126-1001

Mailing address

7621 Chase Rd
Dearborn, MI 48126-1001
Phone (313) 584-7621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302038283MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1124385679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7621 CHASE RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261001",
            "telephone_number": "313-584-7621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7621 CHASE RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261001",
            "telephone_number": "313-584-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAPHA",
        "first_name": "MUSSA",
        "middle_name": "DIB",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302038283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.