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General NPI Number Information
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NPI Number | 1124085436
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Entity Type | Individual
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Provider Name | MALATHI BATHIJA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 44000 W 12 MILE RD SUITE 212
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City | NOVI
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State | MI
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Zip | 48377-2644
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Country | US
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Telephone | 248-347-8285
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Fax | 248-347-8215
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Provider Business Mailing Address
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Address Line | 44000 W 12 MILE RD SUITE 212
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City | NOVI
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State | MI
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Zip | 48377-2644
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Country | US
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Telephone | 248-347-8285
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Fax | 248-347-8215
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 4301072526
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License Number State | MI
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