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General NPI Number Information
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NPI Number | 1164785358
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Entity Type | Individual
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Provider Name | BETTINA JOI MCGRAW M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN ST
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City | DETROIT
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State | MI
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Zip | 48201-2119
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Country | US
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Telephone | 313-993-0139
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Fax |
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Provider Business Mailing Address
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Address Line | 4406 3RD ST
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City | DETROIT
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State | MI
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Zip | 48201-1134
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Country | US
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Telephone | 704-941-9114
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD046475
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0116024643
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301108242
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5315072651
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | DR-0026608
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License Number State | DE
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D0090434
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License Number State | MD
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