Organization
MAYURA MADANI M.D.P.L.L.C.
Active
Parent organization
MAYURA MADANI M.D.P.L.L.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAYURA MADANI M.D.P.L.L.C.
Authorized official
MAYURA MADANI M.D. (PRESIDENT)
(313) 833-4629
Entity
Organization
Contact information
Practice address
4727 ST ANTOINE, STE 402, DETROIT, MI 48201
(313) 833-4629
(313) 833-4648
Mailing address
4727 ST ANTOINE, STE 402, DETROIT, MI 48201
(313) 833-4629
(313) 833-4648
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104788033
—
MI
Enumeration date
04/08/2013
Last updated
04/08/2013
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