Provider Demographics
NPI:1740280569
Name:MIHAILOFF, NEVENA-MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:NEVENA-MARIA
Middle Name:
Last Name:MIHAILOFF
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 1:1266 MARYMAR LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2825
Mailing Address - Country:US
Mailing Address - Phone:313-278-1140
Mailing Address - Fax:313-278-0855
Practice Address - Street 1:1266 MARYMAR LN
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-2825
Practice Address - Country:US
Practice Address - Phone:313-278-1140
Practice Address - Fax:313-278-0855
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINM039159207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0808242521OtherBCBS BCN
MI0808242521OtherBCN
MI0808242521OtherBCN
MIA76842Medicare UPIN