Individual
DIPENKUMAR KANAIYALAL MODI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 JOHN R ST, DETROIT, MI 48201-2013
(313) 576-8780
Mailing address
2411 DORCHESTER DR N APT 203, TROY, MI 48084-3744
(313) 676-0320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301101133
MI
Other
Enumeration date
07/30/2012
Last updated
05/23/2019
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