Individual
MARJAN MOGHADDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
3370 E JEFFERSON AVE, DETROIT, MI 48207-4236
(800) 659-6568
(313) 656-1610
Mailing address
4077 CROOKS RD, ROYAL OAK, MI 48073-2481
(248) 595-2328
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101019748
MI
Other
Enumeration date
06/27/2012
Last updated
03/09/2021
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