Individual provider Active NPI

Yedishtra Naidoo, MD

  • Psychiatry Physician
  • Detroit, MI
National Provider Identifier
1659650406
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301099126 Issued in MI
Practice address
2751 E Jefferson Ave
Detroit, MI 48207-4180
Phone
(313) 993-3434
Fax
(313) 993-3421
NPI assigned
Aug 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301099126 MI Primary

Addresses

Primary practice location

2751 E Jefferson Ave
Detroit, MI 48207-4180

Mailing address

2751 E Jefferson Ave
Detroit, MI 48207-4180
Phone (313) 993-3434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301099126MIMDPsychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1659650406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074180",
            "telephone_number": "313-993-3434",
            "fax_number": "313-993-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074180",
            "telephone_number": "313-993-3434",
            "fax_number": "313-993-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDOO",
        "first_name": "YEDISHTRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301099126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.