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General NPI Number Information
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NPI Number | 1144215492
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Entity Type | Individual
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Provider Name | PARMOD KUMAR MUKHI MD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 14585 NORTHLINE RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2469
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Country | US
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Telephone | 248-763-0501
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Fax | 248-692-5115
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Provider Business Mailing Address
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Address Line | 46275 WHITE PINES DR
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City | NOVI
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State | MI
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Zip | 48374-4309
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Country | US
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Telephone | 248-763-0501
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Fax | 248-692-5115
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | D0083518
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | PM059604
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License Number State | MI
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