Individual
JAINA SABU SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
49409 W CENTRAL PARK, SHELBY TWP, MI 48317-6355
(734) 620-7933
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
4704247931
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704247931
MI
Other
Enumeration date
04/12/2019
Last updated
04/03/2024
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