Healthcare Provider Details

I. General information

NPI: 1497318869
Provider Name (Legal Business Name): SALMA BRINJIKJI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2019
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 W BIG BEAVER RD STE 520
TROY MI
48084-3442
US

IV. Provider business mailing address

5578 SHAUN RD
WEST BLOOMFIELD MI
48322-1620
US

V. Phone/Fax

Practice location:
  • Phone: 248-646-6659
  • Fax:
Mailing address:
  • Phone: 248-660-7019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number5101027649
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: