Male or Other

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)

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

Provider Address