MEDICARE: DEVINDER MAHAJAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician	4301037664	MI
2	207RP1001X	Pulmonary Disease Physician	DM037664	MI

General Provider Information

NPI Number	:	1487624052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVINDER MAHAJAN M.D.

Provider Business Mailing Address
First Line	:	2723 S STATE ST STE 150
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-6188
Country	:	US
Telephone Number	:	734-316-7880
Fax Number	:	888-837-9061

Provider Business Practice Location Address
First Line	:	18181 OAKWOOD BLVD
Second Line	:	SUITE 208
City	:	DEARBORN
State	:	MI
Zip	:	48124-5031
Country	:	US
Telephone Number	:	313-271-5565
Fax Number	:	313-271-1053

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	03/12/2021

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