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General NPI Number Information
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NPI Number | 1205011319
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Entity Type | Organization
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Legal Business Name | GYNECOLOGY AND HOLISTIC CARE PC
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 43211 DALCOMA DR SUITE 4
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-6309
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Country | US
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Telephone | 586-228-7075
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Fax | 586-228-7095
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Provider Business Mailing Address
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Address Line | 43211 DALCOMA DR SUITE 4
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-6309
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Country | US
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Telephone | 586-228-7075
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Fax | 586-228-7095
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | JAMSHID BHAVNAGRI
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Credential | MD
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Telephone | 586-228-7075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | JB040663
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License Number State | MI
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