Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD471023 | PA |
NPI | 1003279126 |
---|---|
Provider Name | Jay Kinariwala |
First Address | Detroit, MI 48235-2624 |
Second Address | Detroit, MI 48235-2624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2016 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103785450 | (05) | PA |