MITUL MODI, MD

Dermatology

Active Individual
NPI: 1649794876

Practice Address

2160 S 1ST AVE
Maywood, IL 60153

Phone: (248) 839-7383

Specialties

Specialty Code Primary License
Pathology - Dermatopathology 207ZD0900X No 125079219 (IL)
Student in an Organized Health Care Education/Training Program 390200000X No -
Dermatology 207N00000X Yes 036164764 (IL)

Frequently Asked Questions

NPI 1649794876 is the National Provider Identifier for MITUL MODI, MD, a Dermatology provider located in Maywood, IL. This NPI was enumerated on July 31, 2017.
MITUL MODI, MD practices at 2160 S 1ST AVE, Maywood, IL 60153.

Quick Facts

NPI
1649794876
Type
Individual
Enumerated
Jul 31, 2017
Last Updated
Jan 16, 2025

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