Healthcare Provider Details

I. General information

NPI: 1033902390
Provider Name (Legal Business Name): GEETIKA GUHA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 S LINDEN RD STE 900
FLINT MI
48532-4068
US

IV. Provider business mailing address

1125 S LINDEN RD STE 900
FLINT MI
48532-4068
US

V. Phone/Fax

Practice location:
  • Phone: 810-235-2004
  • Fax:
Mailing address:
  • Phone: 810-720-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5601014121
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: