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General NPI Number Information
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NPI Number | 1275244980
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Entity Type | Organization
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Legal Business Name | VALIYA HEALTH
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 2230 W LASKEY RD
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City | TOLEDO
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State | OH
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Zip | 43613-3543
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Country | US
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Telephone | 586-871-5261
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Fax |
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Provider Business Mailing Address
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Address Line | 25648 SALEM ST
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City | ROSEVILLE
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State | MI
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Zip | 48066-4468
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Country | US
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Telephone | 586-871-5261
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MANZUR MOIDUNNY
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Credential | MD
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Telephone | 586-871-5261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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