Provider Demographics
NPI:1225724123
Name:HANMANDLU, NADIA AZARA (DO)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:AZARA
Last Name:HANMANDLU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:AZARA
Other - Last Name:AHAMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSA
Mailing Address - Street 1:3901 BEAUBIEN ST RM 3T72
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2196
Mailing Address - Country:US
Mailing Address - Phone:313-745-5533
Mailing Address - Fax:
Practice Address - Street 1:3901 BEAUBIEN ST RM 3T72
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2196
Practice Address - Country:US
Practice Address - Phone:313-745-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program