Healthcare Provider Details

I. General information

NPI: 1578487344
Provider Name (Legal Business Name): PREETI KUMARI YADAV M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

461 W HURON ST STE 107
PONTIAC MI
48341-1601
US

IV. Provider business mailing address

2615 GREENSTONE BLVD APT 301
AUBURN HILLS MI
48326-3759
US

V. Phone/Fax

Practice location:
  • Phone: 623-499-0717
  • Fax:
Mailing address:
  • Phone: 623-499-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4351057018
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: