Healthcare Provider Details
I. General information
NPI: 1639166515
Provider Name (Legal Business Name): RANJIV REGGIE SEHGAL D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/05/2005
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2095 E BIG BEAVER RD STE 300
TROY MI
48083-2372
US
IV. Provider business mailing address
2095 E BIG BEAVER RD STE 300
TROY MI
48083-2372
US
V. Phone/Fax
- Phone: 248-729-7004
- Fax:
- Phone: 248-729-7004
- Fax: 248-729-7207
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2301008204 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: