Provider Demographics
NPI:1780874909
Name:MAJJHOO, ARIEL Q
Entity type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:Q
Last Name:MAJJHOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3113
Mailing Address - Country:US
Mailing Address - Phone:734-682-3309
Mailing Address - Fax:734-682-1488
Practice Address - Street 1:1030 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3113
Practice Address - Country:US
Practice Address - Phone:734-682-3309
Practice Address - Fax:734-682-1488
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010907332084P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5315055796OtherCDS #
MI0951999OtherTYPE 1 BCBS PIN
MI12555637OtherCAQH ID NO.
MI4301090733OtherSTATE LICENSE #
MI1780874909OtherBCBS TYPE 1 (IND) NPI #
MI12555637OtherCAQH ID NO.