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General NPI Number Information
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NPI Number | 1437446820
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Entity Type | Individual
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Provider Name | HIRVA MANSURALI MAMDANI M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4100 JOHN R ST
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City | DETROIT
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State | MI
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Zip | 48201-2013
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Country | US
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Telephone | 800-527-6266
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Fax | 313-576-8627
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Provider Business Mailing Address
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Address Line | 1891 KIRTS BLVD APT 210
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City | TROY
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State | MI
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Zip | 48084
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Country | US
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Telephone | 909-525-0093
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301098222
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 4301098222
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License Number State | MI
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