Healthcare Provider Details

I. General information

NPI: 1467588483
Provider Name (Legal Business Name): ANITA CAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13901 E. JEFFERON AVE.
DETROIT MI
48215-2720
US

IV. Provider business mailing address

31500 TELEGRAPH RD STE 230
BINGHAM FARMS MI
48025-4331
US

V. Phone/Fax

Practice location:
  • Phone: 313-822-0900
  • Fax: 313-822-4202
Mailing address:
  • Phone: 248-593-5845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301058438
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: