Individual provider Active NPI

Abdulqadir M Mussani, M.D.

  • Internal Medicine Physician
  • Southgate, MI
National Provider Identifier
1851318836
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301039494 Issued in MI
Practice address
12815 Northline Rd
Southgate, MI 48195-1109
Phone
(734) 284-2090
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301039494 MI Primary

Addresses

Primary practice location

12815 Northline Rd
Southgate, MI 48195-1109

Mailing address

12815 Northline Rd
Southgate, MI 48195-1109
Phone (734) 284-2090

Other identifiers 1

IdentifierTypeStateIssuer
2097071-10MedicaidMI

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southgate Medical Center PLLC Internal Medicine Current Accepting new patients
Best Medical Center Internal Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

14551 Southfield Rd
Ste 1
Allen Park, MI 48101
Phone (313) 299-3420

12815 Northline Rd
Southgate, MI 48195
Phone (734) 284-2090

13460 Fort St
Southgate, MI 48195
Phone (313) 263-5961

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1851318836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12815 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951109",
            "telephone_number": "734-284-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951109",
            "telephone_number": "734-284-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSANI",
        "first_name": "ABDULQADIR",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301039494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2097071-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; 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.