Healthcare Provider Details

I. General information

NPI: 1225956550
Provider Name (Legal Business Name): BIPLAV GHIMIRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 W 13 MILE RD, LL-SOUTH CLINIC
ROYAL OAK MI
48073
US

IV. Provider business mailing address

3535 W 13 MILE RD, LL-SOUTH CLINIC
ROYAL OAK MI
48073
US

V. Phone/Fax

Practice location:
  • Phone: 248-551-3000
  • Fax:
Mailing address:
  • Phone: 248-551-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4351056513
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4351056513
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: