Organization
NORTHWESTERN PSYCHIATRY & COUNSELING CENTER PC
Active
Organization
NORTHWESTERN PSYCHIATRY & COUNSELING CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHU MENDIRATTA MD (MD)
(248) 945-9370
Entity
Organization
Contact information
Practice address
26699 W 12 MILE RD STE 100, SOUTHFIELD, MI 48034-1578
(248) 945-9370
(248) 945-9377
Mailing address
26699 W 12 MILE RD STE 100, SOUTHFIELD, MI 48034-1578
(248) 945-9370
(248) 945-9377
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MM048520
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2606351352
BCBCM
MI
Enumeration date
02/02/2007
Last updated
06/30/2014
Update your record
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