Healthcare Provider Details

I. General information

NPI: 1265685143
Provider Name (Legal Business Name): INAD NAIM JANINEH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 ROCHESTER RD
TROY MI
48085-3374
US

IV. Provider business mailing address

2490 S ROCHESTER RD
ROCHESTER HILLS MI
48307-3817
US

V. Phone/Fax

Practice location:
  • Phone: 586-263-2300
  • Fax: 586-263-2614
Mailing address:
  • Phone: 248-212-0116
  • Fax: 248-212-0143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5315036001
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5101017672
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: