Provider Demographics
NPI:1124737689
Name:ISRAEL, MAGDANAH SALOMA
Entity type:Individual
Prefix:
First Name:MAGDANAH
Middle Name:SALOMA
Last Name:ISRAEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14030 MINOCK DR
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2935
Mailing Address - Country:US
Mailing Address - Phone:586-420-0026
Mailing Address - Fax:
Practice Address - Street 1:14030 MINOCK DR
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-2935
Practice Address - Country:US
Practice Address - Phone:586-420-0026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-22
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula