Provider Demographics
NPI:1265685143
Name:JANINEH, INAD NAIM (DO)
Entity Type:Individual
Prefix:
First Name:INAD
Middle Name:NAIM
Last Name:JANINEH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15855 19 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-3504
Mailing Address - Country:US
Mailing Address - Phone:586-263-2300
Mailing Address - Fax:586-263-2614
Practice Address - Street 1:5600 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3374
Practice Address - Country:US
Practice Address - Phone:586-263-2300
Practice Address - Fax:586-263-2614
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017672208600000X
MI5315036001208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery