Provider Demographics
NPI:1235174996
Name:ARREY MENSAH, ANNIE AGBOR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:AGBOR
Last Name:ARREY MENSAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:29355 NORTHWESTERN HWY
Mailing Address - Street 2:STE 300
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1045
Mailing Address - Country:US
Mailing Address - Phone:248-396-9563
Mailing Address - Fax:248-304-8906
Practice Address - Street 1:27155 HAMPSTEAD BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331
Practice Address - Country:US
Practice Address - Phone:248-396-9563
Practice Address - Fax:248-304-8906
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069914207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H34207Medicare UPIN
OHAR4179571Medicare ID - Type Unspecified
3506358961OtherBCBS