Provider Demographics
NPI:1649212952
Name:MSIBI, BHEKUMUSA (DO)
Entity Type:Individual
Prefix:DR
First Name:BHEKUMUSA
Middle Name:
Last Name:MSIBI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 ASHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-1219
Mailing Address - Country:US
Mailing Address - Phone:989-772-1500
Mailing Address - Fax:989-772-9301
Practice Address - Street 1:1970 ASHLAND DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-1219
Practice Address - Country:US
Practice Address - Phone:989-772-1500
Practice Address - Fax:989-772-9301
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012162208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI12-00182OtherPHYSICIANS HLTH PLAN
MI355370019OtherFED EMP PROG BCBS
MI4294113Medicaid
MIP95344OtherBLUE CARE NETWORK
MI3553701064OtherBLUE CROSS BLUE SHIELD
MI1008811OtherMCLAREN HEALTH PLAN
MI3553701064OtherBLUE CROSS BLUE SHIELD