Individual
DR. MAYURA S MADANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4160 JOHN R STREET, DETROIT, MI 48201
(313) 833-4629
(313) 833-4648
Mailing address
4160 JOHN R STREET, DETROIT, MI 48201-1303
(248) 709-6596
(313) 833-4648
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301062772
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104788033
—
MI
Enumeration date
12/14/2006
Last updated
12/19/2019
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