Dr. Badiollah M. Manshady MD
Full Name
Dr. Badiollah Movaffaghy Manshady MD
NPI Number
1790703536
NPI Type
Individual Provider
Gender
Male
Enumeration Date
07/18/2006
Specialties
(Taxonomies)Name
Code
207RG0300X
207R00000X
207RR0500X
Primary Taxonomy
No
No
No
Licenses
State
Michigan
License Number
BM033580
Contact
Information
Purpose
Mailing
Location
Address
18633 MACK AVE
18633 MACK AVE
City
Detroit
Detroit
State
MI
MI
Postal Code
48236
48236
Country
US
US
Telephone Number
(313) 886-5755
(313) 886-5755
Identifiers
Identifier
1393074
1108204451
Identifier State
MI
MI
Identifier Issuer
Unknown
BLUE SHIELD
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/09/2007