Individual
MASOUMEH KHOSRAVIARDAKANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4201 SAINT ANTOINE ST STE 8D, DETROIT, MI 48201-2153
(313) 745-4275
(313) 577-4641
Mailing address
732 EAGLE AVE, ANN ARBOR, MI 48103-8887
(734) 255-0349
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704276401
MI
Other
Enumeration date
08/11/2019
Last updated
08/11/2019
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