Maryam Blackeagle
NPI #1104285881 in Dearborn Heights, Michigan
Provider Information
- NPI Number
- 1104285881
- Entity Type
- Individual
- Name
- Maryam Blackeagle
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Licensed Practical Nurse
- Enumeration Date
- Feb 23, 2016
- Last Updated
- Feb 23, 2016
Practice Location
- Address
- 8445 NORBORNE AVE
- City
- Dearborn Heights
- State
- Michigan
- ZIP Code
- 48127-1125
- Phone
- (734) 727-3010
Specialties & Taxonomy Codes
| Specialty |
|---|
| Licensed Practical Nurse |
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