Provider Demographics
NPI:1003921610
Name:BAKLEH, MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:BAKLEH
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 1:5040 VILLA LINDE PKWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3445
Mailing Address - Country:US
Mailing Address - Phone:810-230-0788
Mailing Address - Fax:
Practice Address - Street 1:5040 VILLA LINDE PKWY
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3445
Practice Address - Country:US
Practice Address - Phone:810-230-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMB056774207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMB056774OtherBLUE CROSS BLUE SHIELD
MI0996126OtherHEALTH PLUS OF MICHIGAN
MIMB056774OtherBLUE CARE NETWORK
MI1008999OtherMCLAREN HEALTH ADVANTAGE
MIF25123OtherHEALTH ALLIANCE PLAN
MI1008999OtherMCLAREN HEALTH PLAN
MI16359OtherMCARE CLAIMS
MIP00068213OtherPALMETTO GBA RAILROAD
MIF25123OtherHEALTH ALLIANCE PLAN