Healthcare Provider Details

I. General information

NPI: 1427675420
Provider Name (Legal Business Name): MIRIAM BISHAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25150 FORD RD STE 200
DEARBORN HEIGHTS MI
48127-3163
US

IV. Provider business mailing address

25150 FORD RD STE 200
DEARBORN HEIGHTS MI
48127-3163
US

V. Phone/Fax

Practice location:
  • Phone: 313-277-0400
  • Fax:
Mailing address:
  • Phone: 313-277-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4351046745
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: