Healthcare Provider Details

I. General information

NPI: 1427602929
Provider Name (Legal Business Name): ASHWINI GULWADI, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W LIBERTY ST APT 360
ANN ARBOR MI
48104-1365
US

IV. Provider business mailing address

101 W LIBERTY ST APT 360
ANN ARBOR MI
48104-1365
US

V. Phone/Fax

Practice location:
  • Phone: 734-984-2228
  • Fax:
Mailing address:
  • Phone: 734-984-2228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ASHWINI GULWADI
Title or Position: EMPLOYEE
Credential: MD
Phone: 734-984-2228