Individual
MS. CARLESHA ASHANTI BLADES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4201 ST. ANTOINE BOULEVARD, DETROIT, MI 48201
(313) 745-3000
(313) 993-8669
Mailing address
3730 4TH ST, DETROIT, MI 48201
(248) 763-6757
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4321049799
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/04/2022
Last updated
12/05/2022
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