Healthcare Provider Details

I. General information

NPI: 1154764652
Provider Name (Legal Business Name): SHIKHA KALRA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHIKHA GARG DO

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W 13 MILE RD
ROYAL OAK MI
48073-6712
US

IV. Provider business mailing address

26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 248-898-5000
  • Fax: 248-898-1264
Mailing address:
  • Phone: 947-522-1860
  • Fax: 947-522-0307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101020688
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number5101020688
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: