Individual
DR. ASHISH M MODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-5111
(313) 745-3500
Mailing address
4572 RIVERS EDGE DR, TROY, MI 48098-4114
(248) 267-9247
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301055374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4027652
ECFMG NUMBER
—
01
—
4301055374
STATE LICENSE NUMBER
MI
Enumeration date
05/19/2006
Last updated
04/02/2025
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