Individual
DR. TIFFANY DAWN PROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301108458
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2015
Last updated
11/19/2018
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