MEDICARE: DR. USHA R MODI MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301047338	MI

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4453517	OTHER	MI	AETNA
2	1112517472	OTHER	MI	BLUE CROSS BLUE SHIELD
3	1117472	OTHER	MI	HEALTH PLUS
4	204386	OTHER	MI	HEALTH ADVANTAGE NETWORK
5	C2918	OTHER	MI	MCARE
6	3814414003	OTHER	MI	CIGNA
7	204386	OTHER	MA	MCLAREN HEALTH PLAN
8	B49123	OTHER	MI	HEALTH NET FEDERAL
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	B49123	OTHER	MI	HEALTH ALLIANCE PLAN
11	110027153/CD3613	OTHER	MI	METRAHEALTH

NPI Number	:	1417946724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. USHA R MODI MD

Provider Business Mailing Address
First Line	:	401 S BALLENGER HWY
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48532-3638
Country	:	US
Telephone Number	:	810-342-1000
Fax Number	:	810-342-1590

Provider Business Practice Location Address
First Line	:	1314 S LINDEN RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48532-3456
Country	:	US
Telephone Number	:	810-342-1700
Fax Number	:	810-720-4035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	07/08/2007

1314 S LINDEN RD STE A
FLINT, MI
48532-3456

Practice Phone: 810-342-1750
Practice Fax: