Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 5101020555 | MI |
N | 111NI0900X | Internist | 5101020555 | MI |
Y | 207RI0200X | Infectious Disease | 5101020555 | MI |
NPI | 1073853958 |
---|---|
Provider Name | Avnish Sandhu |
First Address | Canton, MI 48187 |
Second Address | Detroit, MI 48235-2614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2013 |
Last Update Date | 04/01/2022 |