Provider Demographics
NPI:1497715890
Name:MABRY, HELEN CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:CATHERINE
Last Name:MABRY
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 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1860
Mailing Address - Fax:
Practice Address - Street 1:5400 FORT ST STE 230
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-4630
Practice Address - Country:US
Practice Address - Phone:734-642-2185
Practice Address - Fax:734-467-5544
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3502086X0206X
MI4301108801208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI13916Medicare UPIN