Provider Demographics
NPI:1205896123
Name:MRA PSYCHIATRICS, PC
Entity type:Organization
Organization Name:MRA PSYCHIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAZVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-423-0672
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-0035
Mailing Address - Country:US
Mailing Address - Phone:989-423-0672
Mailing Address - Fax:989-466-6454
Practice Address - Street 1:733 W WARWICK DR UNIT A
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1115
Practice Address - Country:US
Practice Address - Phone:989-423-0672
Practice Address - Fax:989-466-6454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062869261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2602911691OtherBCBSM
MI2602911691OtherBCBSM
MI0P27450Medicare ID - Type UnspecifiedMRA MEDICARE NUMBER