Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kefah Abbas Mazloum

Individual provider Family Nurse Practitioner · NPI 1356093553

Kefah Abbas Mazloum is a Nurse Practitioner in Jackson, Michigan. Qualified in 2022, 4 years ago. Practices with Wyandotte Urgent Care Clinic, a 16-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
4
Licensed in
MI
In the registry since
2022
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Practice location Address checks out

205 N East Ave
Jackson, MI 49201-1753
Phone: (517) 205-7836
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 5446 Bingham St, Dearborn, MI 48126-3306 — (313) 358-0203
  • 25325 Ford Rd Ste 200, Dearborn, MI 48128-1086 — (313) 887-7774
  • 2799 W Grand Blvd, Detroit, MI 48202-2608 — (800) 653-6568

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 4704341497 (MI)

Record details

NPI number1356093553
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 19, 2022
Last updated in NPPESMarch 17, 2025
Certification dateMarch 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Wyandotte Urgent Care Clinic — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Jackson