Healthcare Provider Details

I. General information

NPI: 1093562365
Provider Name (Legal Business Name): ANUBHAV RIJAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3230 BEECHER RD STE 1
FLINT MI
48532-3604
US

IV. Provider business mailing address

G3230 BEECHER RD STE 1
FLINT MI
48532-3604
US

V. Phone/Fax

Practice location:
  • Phone: 810-342-5656
  • Fax: 810-342-5600
Mailing address:
  • Phone: 810-342-5656
  • Fax: 810-342-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351053078
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: