Individual provider Active NPI

Mahdokht M Rabbani, MD

  • Diagnostic Ultrasound Physician
  • Saint Clair Shores, MI
National Provider Identifier
1831216753
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
4301047003 Issued in MI
Practice address
20225 E 9 Mile Rd
Suite A2
Saint Clair Shores, MI 48080-1775
Phone
(586) 775-4711
Fax
(586) 775-4050
NPI assigned
Mar 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X 4301047003 MI Primary

Addresses

Primary practice location

20225 E 9 Mile Rd
Suite A2
Saint Clair Shores, MI 48080-1775

Mailing address

43750 Garfield Rd
Suite 104
Clinton TWP, MI 48038-1135
Phone (586) 226-6865

Other identifiers 1

IdentifierTypeStateIssuer
4416403MedicaidMI

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

NPI Registry JSON

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831216753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43750 GARFIELD RD",
            "address_2": "SUITE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381135",
            "telephone_number": "586-226-6865",
            "fax_number": "586-226-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20225 E 9 MILE RD",
            "address_2": "SUITE A2",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "586-775-4711",
            "fax_number": "586-775-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABBANI",
        "first_name": "MAHDOKHT",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MI",
            "license": "4301047003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4416403",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.