| Doctor Name: | DR. MIA ELISE LAYNE |
| NPI Number: | 1417210931 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 4301101221 |
| Business Practice Address: | 3990 John R St Mailbox #165 Detroit, MI - 482012018 |
| Business Phone Number: | 3139934030 |
| Business Fax Number: | 3139934116 |
| Mailing Address: | 700 Lincoln Ln, Apt. 1702 DEARBORN |
| State: | MI |
| Postal Code: | 481266103 |
| Phone Number: | 3139084680 |
| Fax Number: | |
| NPI Enumeration Date: | 06/19/2012 |
| NPI Last Update Date: | 06/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 4301101221 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |