Healthcare Provider Details

I. General information

NPI: 1760170534
Provider Name (Legal Business Name): ASHISH DAHIYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22301 FOSTER WINTER DR
SOUTHFIELD MI
48075-3707
US

IV. Provider business mailing address

22301 FOSTER WINTER DR
SOUTHFIELD MI
48075-3707
US

V. Phone/Fax

Practice location:
  • Phone: 248-849-3541
  • Fax: 248-849-2899
Mailing address:
  • Phone: 248-849-3541
  • Fax: 248-849-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number4351055971
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: