Individual
DR. MADANA JEEVANANDAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(514) 515-8052
Mailing address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(514) 515-8052
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301-106057
MI
Other
Enumeration date
01/14/2015
Last updated
02/15/2015
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