Healthcare Provider Details
I. General information
NPI: 1780874909
Provider Name (Legal Business Name): DR. ARIEL Q MAJJHOO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/25/2007
Last Update Date: 06/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1030 N MONROE ST
MONROE MI
48162-3113
US
IV. Provider business mailing address
1030 N MONROE ST
MONROE MI
48162-3113
US
V. Phone/Fax
- Phone: 734-682-3309
- Fax: 734-682-1488
- Phone: 734-682-3309
- Fax: 734-682-1488
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P2900X |
| Taxonomy | Pain Medicine (Psychiatry & Neurology) Physician |
| License Number | 4301090733 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | 4301090733 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: