Provider Demographics
NPI:1164590618
Name:MOHINDRA, HEM P (MD)
Entity Type:Individual
Prefix:
First Name:HEM
Middle Name:P
Last Name:MOHINDRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HENRY FORD MEDICAL GROUP - DETROIT NORTHWEST
Mailing Address - Street 2:7800 WEST OUTER DRIVE
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-653-2300
Mailing Address - Fax:
Practice Address - Street 1:HENRY FORD MEDICAL GROUP - DETROIT NORTHWEST
Practice Address - Street 2:7800 WEST OUTER DRIVE
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-653-2300
Practice Address - Fax:313-653-2660
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301032922207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HM032922OtherCHAMPUS-CHAMPUS
700H262220OtherBLUE CROSS-BLUE CROSS
MI322791110Medicaid
HM032922OtherCOMMERCIAL-COMMERCIAL NUMBER
B48096Medicare UPIN
MI322791110Medicaid