Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301500210 | MI |
N | 111NI0900X | Internist | 4301500210 | MI |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 4301500210 | MI |
NPI | 1023437043 |
---|---|
Provider Name | Priyanka Bikkina |
First Address | Kalamazoo, MI 49007 |
Second Address | Portage, MI 49024-3831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 16/07/2020 |