Provider Demographics
NPI:1144357427
Name:SOI, MEENAKSHI (MD)
Entity type:Individual
Prefix:
First Name:MEENAKSHI
Middle Name:
Last Name:SOI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 FORT STREET
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-0000
Mailing Address - Country:US
Mailing Address - Phone:734-676-0800
Mailing Address - Fax:
Practice Address - Street 1:2421 FORT STREET
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-0000
Practice Address - Country:US
Practice Address - Phone:734-676-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301037734208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3101562Medicaid
MIOH36164007Medicare ID - Type Unspecified
MI3101562Medicaid