Ponniah Mohan MD PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

PM039179 Issued in MI

Legal business name

PONNIAH MOHAN MD PC

Practice address

11446 E 13 Mile Rd
Suite B
Warren, MI 48093-6571

Phone

(586) 574-2020

Fax

(586) 574-2919

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ponniah Mohan, MD

Title

Physician

Phone

(586) 574-2020

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Husain Arastu, MD

  • Pediatric Adolescent Medicine Physician
  • Warren, MI
  • NPI 1528017555
  NPD (past)

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1801061957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11446 E 13 MILE RD",
            "address_2": "SUITE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480936571",
            "telephone_number": "586-574-2020",
            "fax_number": "586-574-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11446 E 13 MILE RD",
            "address_2": "SUITE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480936571",
            "telephone_number": "586-574-2020",
            "fax_number": "586-574-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONNIAH MOHAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "MOHAN",
        "authorized_official_first_name": "PONNIAH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "586-574-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "PM039179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "3505021342",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1682676",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia A Pohlod-Martin, CRNA
• Gerald E Poirier, MA LLP
• Laura Ann Poirier
• Diane Marie Pokorski, CRNA
• Catherine M Pokropek, M.D.
• Christina Maria Pope, LPC
• Aimee Antoinette Popofski, DPM
• George C Popp, MD
• Brenda Michele Porter, MPT
• Avionce Posey

• Pediatrics Physician in Warren, MI
• Providers in Warren, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.