Individual
DR. BADIOLLAH MOVAFFAGHY MANSHADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18633 MACK AVE, DETROIT, MI 48236
(313) 886-5755
(313) 886-3609
Mailing address
18633 MACK AVE, DETROIT, MI 48236
(313) 886-5755
(313) 886-3609
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
BM033580
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
BM033580
MI
207RR0500X
Rheumatology Physician
BM033580
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108204451
BLUE SHIELD
MI
05
—
1393074
—
MI
Enumeration date
07/18/2006
Last updated
09/11/2025
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