Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 4301046983 | MI |
NPI | 1285667097 |
---|---|
Provider Name | Dr. Kalpana A Choksi |
First Address | Detroit, MI 48219-1217 |
Second Address | Detroit, MI 48219-1217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3055657 | (05) | MI |
E16070 | (02) | MI |