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NPI 1114981917

NPI 1114981917 : SANJAY BATRA MD : DETROIT, MI

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General NPI Number Information
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    NPI Number           |    1114981917
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    Entity Type          |    Individual 
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    Provider Name        |    SANJAY BATRA MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/17/2006
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    Last Update Date     |    02/23/2017
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Provider Practice Location Address
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    Address Line         |    22201 MOROSS ROAD SUITE 356
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    City                 |    DETROIT
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    State                |    MI
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    Zip                  |    48236
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    Country              |    US
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    Telephone            |    313-343-7444
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    Fax                  |    313-343-7999
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Provider Business Mailing Address
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    Address Line         |    22201 MOROSS ROAD SUITE 356
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    City                 |    DETROIT
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    State                |    MI
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    Zip                  |    48236
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    Country              |    US
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    Telephone            |    313-343-7444
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    Fax                  |    313-343-7999
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208G00000X
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    Taxonomy Name        |    Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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    License Number       |    4301056593
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    License Number State |    MI
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