Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 4301068779 | MI |
N | 207KA0200X | Allergist | 4301068779 | MI |
Y | 2080P0201X | Pediatric Allergist | 4301068779 | MI |
N | 2080P0214X | Pediatric Pulmonologist | 4301068779 | MI |
NPI | 1932168408 |
---|---|
Provider Name | Devang Ratikumar Doshi |
First Address | Royal Oak, MI 48073-3507 |
Second Address | Royal Oak, MI 48073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 20/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1932168408 | (05) | MI |
350F361320 | BCBSM (01) | MI |