Provider Demographics
NPI:1043549165
Name:JOSEPHINE ISKANDER, MD PLLC
Entity type:Organization
Organization Name:JOSEPHINE ISKANDER, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISKANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-841-1721
Mailing Address - Street 1:906 MAJESTIC
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-3575
Mailing Address - Country:US
Mailing Address - Phone:248-841-1721
Mailing Address - Fax:
Practice Address - Street 1:44199 DEQUINDRE RD
Practice Address - Street 2:STE 304
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1128
Practice Address - Country:US
Practice Address - Phone:248-964-6407
Practice Address - Fax:248-964-9644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-19
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301085250275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit