Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 20A10392 | CA |
N | 208000000X | Pediatrician | 5101019086 | MI |
Y | 2080P0202X | Pediatric Cardiologist | 5101019086 | MI |
NPI | 1083843254 |
---|---|
Provider Name | Dr. Heidi Sonali Magdo |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2009 |
Last Update Date | 23/11/2021 |