Healthcare Provider Details

I. General information

NPI: 1124649892
Provider Name (Legal Business Name): REEMA NAMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E 5TH ST STE 300
FLINT MI
48502-1641
US

IV. Provider business mailing address

28050 GRAND RIVER AVE
FARMINGTON HILLS MI
48336-5919
US

V. Phone/Fax

Practice location:
  • Phone: 810-406-4246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901400533
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: