Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 4301092050 | MI |
NPI | 1003013921 |
---|---|
Provider Name | Amit Bahl |
First Address | Troy, MI 48084-1744 |
Second Address | Royal Oak, MI 48073-6712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 22/10/2015 |