Provider Demographics
NPI:1376962514
Name:ABUSHANAB, DANIA (MD)
Entity Type:Individual
Prefix:
First Name:DANIA
Middle Name:
Last Name:ABUSHANAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3766 BREWSTER ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1016
Mailing Address - Country:US
Mailing Address - Phone:313-600-4669
Mailing Address - Fax:855-250-3025
Practice Address - Street 1:4700 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-4124
Practice Address - Country:US
Practice Address - Phone:313-600-4669
Practice Address - Fax:855-250-3025
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301500408207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism