Provider Demographics
NPI:1427171677
Name:CERGHET, MIRELA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MIRELA
Middle Name:
Last Name:CERGHET
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2799 W GRAND BLVD
Mailing Address - Street 2:K11
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2608
Mailing Address - Country:US
Mailing Address - Phone:313-916-7207
Mailing Address - Fax:313-916-3014
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:K11
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-7207
Practice Address - Fax:313-916-3014
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010797972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology