Madani, Mayura S
Madani, Mayura S is an sole proprietor health care provider with primary practice located at 4160 John R Street , Detroit MI 48201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Madani, Mayura S can be contacted via phone (313) 833-4629.Contact Information
Primary practice address
4160 John R Street
Detroit MI 48201
Phone: (313) 833-4629
Fax: (313) 833-4648
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 4301062772 | Michigan |
Profile Details
| NPI number | 1992867204 |
|---|---|
| LBN Legal business name | Madani, Mayura S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2006 |
| Last updated | Dec 19th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992867204 | NPPES |
| Michigan | MEDICAID | 104788033 |
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