Individual
MADHUMITA JENA MOHANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201
(313) 576-1000
Mailing address
4646 JOHN R, DETROIT, MI 48201
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301069697
MI
207RN0300X
Nephrology Physician
Primary
4301069697
MI
Other
Enumeration date
06/01/2006
Last updated
06/07/2018
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