Healthcare Provider Details

I. General information

NPI: 1063520211
Provider Name (Legal Business Name): MAHNAZ S MAFEE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33330 PALMER RD
WESTLAND MI
48186-5529
US

IV. Provider business mailing address

44429 HARMONY LN
BELLEVILLE MI
48111-2409
US

V. Phone/Fax

Practice location:
  • Phone: 734-729-3080
  • Fax: 734-729-9435
Mailing address:
  • Phone: 734-697-7431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704184387
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: