Healthcare Provider Details

I. General information

NPI: 1437846193
Provider Name (Legal Business Name): VANIAWALA PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S SAGINAW ST
FLINT MI
48502-1803
US

IV. Provider business mailing address

420 S SAGINAW ST
FLINT MI
48502-1803
US

V. Phone/Fax

Practice location:
  • Phone: 810-762-1444
  • Fax: 810-762-1448
Mailing address:
  • Phone: 810-762-1444
  • Fax: 810-762-1448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BHAVNA VANIAWALA
Title or Position: PRESIDENT
Credential: MD
Phone: 810-762-1444