Provider Demographics
NPI:1831259308
Name:JUNAID GHADAI MD PC
Entity type:Organization
Organization Name:JUNAID GHADAI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:JUNAID
Authorized Official - Middle Name:M
Authorized Official - Last Name:GHADAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-386-0333
Mailing Address - Street 1:4152 DIX HWY
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146
Mailing Address - Country:US
Mailing Address - Phone:313-386-0333
Mailing Address - Fax:313-386-0345
Practice Address - Street 1:4152 DIX HWY
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146
Practice Address - Country:US
Practice Address - Phone:313-386-0333
Practice Address - Fax:313-386-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010732902084P0800X
MI43010700922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4761764Medicaid
P00118096OtherMEDICARE RAILROAD
JG070092OtherBC LISENSE