Healthcare Provider Details

I. General information

NPI: 1104763267
Provider Name (Legal Business Name): MONICA DEVI YERRAMSETTI MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HENRY FORD JACKSON HOSPITAL PEDIATRICS DEPARTMENT 22201 MOROSS RD, SUITE 80
DETROIT MI
48236
US

IV. Provider business mailing address

HENRY FORD JACKSON HOSPITAL PEDIATRICS DEPARTMENT 22201 MOROSS RD, SUITE 80
DETROIT MI
48236
US

V. Phone/Fax

Practice location:
  • Phone: 313-343-3800
  • Fax: 313-343-4756
Mailing address:
  • Phone: 313-343-3800
  • Fax: 313-343-4756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: