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PONNIAH MOHAN MD PC NPI 1801061957


NPI Information

NPI: 1801061957
Provider Name: PONNIAH MOHAN MD PC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
11446 E 13 MILE RD
SUITE B
WARREN, MI
ZIP 48093
Phone: (586) 574-2020
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PONNIAH MOHAN MD PC is a pediatrics in Warren, MI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. PONNIAH MOHAN MD PC NPI is 1801061957. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11446 E 13 MILE RD
SUITE B
WARREN, MI
ZIP 48093-571
Phone: (586) 574-2020
Fax: (586) 574-2919

The provider's authorized official is Ponniah Mohan .
The authorized official title is Physician and has the following contact phone number (586) 574-2020.

The enumeration date for this NPI number is 4/29/2008 and was last updated on 5/6/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsPM039179MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11682676MEDICAIDMICHIGAN
23505021342OTHERMICHIGANBLUE CROSS BLUE SHIELD OF MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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