Organization
PEDIATRIC ANESTHESIA ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABBOY NAIDU MOHAN M.D. (AUTHORIZED REPRESENTATIVE)
(313) 966-0965
Entity
Organization
Contact information
Practice address
3901 BEAUBIEN ST, DETROIT, MI 48201-2119
(313) 966-0965
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
06/19/2006
Last updated
09/19/2007
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