Provider Demographics
NPI:1093905093
Name:MUSHTAQ, TEHMINA (MD)
Entity Type:Individual
Prefix:
First Name:TEHMINA
Middle Name:
Last Name:MUSHTAQ
Suffix:
Gender:F
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:OAKWOOD ANNAPOLIS HOSPITAL
Mailing Address - Street 2:33155 ANNAPOLIS
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184
Mailing Address - Country:US
Mailing Address - Phone:734-467-4000
Mailing Address - Fax:
Practice Address - Street 1:OAKWOOD ANNAPOLIS HOSPITAL
Practice Address - Street 2:33155 ANNAPOLIS
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184
Practice Address - Country:US
Practice Address - Phone:734-467-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301090887207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine