Healthcare Provider Details

I. General information

NPI: 1184076952
Provider Name (Legal Business Name): ROVIN SAXENA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44405 WOODWARD AVE
PONTIAC MI
48341-5023
US

IV. Provider business mailing address

31369 PICKFORD AVE
LIVONIA MI
48152-4607
US

V. Phone/Fax

Practice location:
  • Phone: 248-858-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301110454
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: