Healthcare Provider Details

I. General information

NPI: 1457842965
Provider Name (Legal Business Name): RIKHEV KASHYAP DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32270 TELEGRAPH RD STE 220B
BINGHAM FARMS MI
48025-2456
US

IV. Provider business mailing address

32270 TELEGRAPH RD STE 220B
BINGHAM FARMS MI
48025-2456
US

V. Phone/Fax

Practice location:
  • Phone: 248-480-9080
  • Fax:
Mailing address:
  • Phone: 248-480-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number318582
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number5101028209
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: