Provider Demographics
NPI:1134803638
Name:ADI, MOHAMAD BESHER (MD)
Entity type:Individual
Prefix:
First Name:MOHAMAD BESHER
Middle Name:
Last Name:ADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19251 MACK AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-343-3329
Mailing Address - Fax:
Practice Address - Street 1:19251 MACK AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-343-3329
Practice Address - Fax:313-343-7784
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program