Most Relevant Information
Provider Data
| NPI Number: | 1003379314 |
| Provider Name: | JAINA SABU SAMUEL |
| Entity Type: | Individual |
| Taxonomy Code: | 163WM0705X |
| Specialty: | Registered Nurse |
| License Number: | 4704247931 |
Most Important Dates
| Enumeration Date: | 04/12/2019 |
| Last Updated: | 04/03/2024 |
Provider Practice Location
22101 MOROSS RD
DETROIT
MI
482362148
Practice Location Phone/Fax
| Phone: | 3133434000 |
| Fax: |
Provider Mailing Location
49409 W CENTRAL PARK
SHELBY TWP
MI
483176355
Provider Mailing Phone/Fax
| Phone: | 7346207933 |
| Fax: |