MEDICARE: ANUPAMA VANSADIA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0000X	Obstetrics Physician	430108095	MI

General Provider Information

NPI Number	:	1063622454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANUPAMA VANSADIA M.D.

Provider Business Mailing Address
First Line	:	54146 DEER RIDGE CT
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-7300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 N ROCHESTER RD STE 210
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-4378
Country	:	US
Telephone Number	:	248-650-1534
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/20/2022

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