Provider Demographics
NPI:1356324503
Name:DANISH, HOMAIRA N (MD)
Entity Type:Individual
Prefix:DR
First Name:HOMAIRA
Middle Name:N
Last Name:DANISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MYRA
Other - Middle Name:
Other - Last Name:DANISH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4600 INVESTMENT DR
Mailing Address - Street 2:STE 360
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098
Mailing Address - Country:US
Mailing Address - Phone:248-267-5004
Mailing Address - Fax:248-267-5007
Practice Address - Street 1:4600 INVESTMENT DR
Practice Address - Street 2:STE 360
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098
Practice Address - Country:US
Practice Address - Phone:248-267-5004
Practice Address - Fax:248-267-5007
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068137207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4306475Medicaid
MI4306475Medicaid
H23687Medicare UPIN