Provider Demographics
NPI:1346360229
Name:PURAKAL, JOYCE CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:CATHERINE
Last Name:PURAKAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21000 E 12 MILE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1156
Mailing Address - Country:US
Mailing Address - Phone:586-447-5100
Mailing Address - Fax:586-447-5090
Practice Address - Street 1:21000 E 12 MILE RD STE 102
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1156
Practice Address - Country:US
Practice Address - Phone:586-447-5100
Practice Address - Fax:586-447-5090
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301081983207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIJP081983OtherBCBS
MI0E07871006Medicare PIN