OrganizationActive
Center for Individualized Medicine PLLC
NPI 1760814289 · Child & Adolescent Psychiatry Physician · Wyandotte, MI
Provider details
- NPI number
- 1760814289
- Entity type
- Organization
- Primary specialty
- Child & Adolescent Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Surjit Mahal, Owner(734) 324-8000
- License
- 4301046425 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1404 Biddle Ave
Wyandotte, MI 48192-3706
Phone: (734) 624-8000
Fax: (734) 326-1443
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 251921
West Bloomfield, MI 48325-1921
Registry dates
- Enumerated
- 2013-08-07
- Last updated
- 2013-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.