Provider Demographics
NPI:1710929625
Name:RAY, MIHIR KUMAR (PT)
Entity Type:Individual
Prefix:
First Name:MIHIR
Middle Name:KUMAR
Last Name:RAY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34600 QUAKER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3603
Mailing Address - Country:US
Mailing Address - Phone:248-877-3740
Mailing Address - Fax:
Practice Address - Street 1:34600 QUAKER VALLEY RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-3603
Practice Address - Country:US
Practice Address - Phone:248-877-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501007847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2204222382032Medicare ID - Type UnspecifiedMEDICARE PART B NUMBER