Healthcare Provider Details

I. General information

NPI: 1902465305
Provider Name (Legal Business Name): ANKIT DUGGAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3230 BEECHER RD
FLINT MI
48532-3604
US

IV. Provider business mailing address

G3230 BEECHER RD
FLINT MI
48532-3604
US

V. Phone/Fax

Practice location:
  • Phone: 810-342-5800
  • Fax: 810-342-5810
Mailing address:
  • Phone: 810-342-5800
  • Fax: 810-342-5810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301507384
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301507384
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: