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Organization
PRAVEEN MODI, MD, PC
Active
Organization
PRAVEEN MODI, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAVEEN MODI MD (OWNER)
(248) 830-6697
Entity
Organization
Contact information
Practice address
3200 PINE LAKE RD, WEST BLOOMFIELD, MI 48324-1951
(248) 830-6697
(248) 676-0814
Mailing address
43181 SANDSTONE DR, NOVI, MI 48377-2718
(248) 830-6697
(248) 676-0814
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4620532
—
MI
Enumeration date
10/01/2007
Last updated
06/18/2019
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