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General NPI Number Information
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NPI Number | 1346400868
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Entity Type | Organization
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Legal Business Name | V GOBURDHUN MD PC
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 14555 LEVAN RD 403
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City | LIVONIA
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State | MI
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Zip | 48154-5083
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Country | US
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Telephone | 734-462-4000
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Fax | 734-462-5997
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Provider Business Mailing Address
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Address Line | 14555 LEVAN RD 403
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City | LIVONIA
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State | MI
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Zip | 48154-5083
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Country | US
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Telephone | 734-462-4000
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Fax | 734-462-5997
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. VIJAY GOBURDHUN
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Credential | M.D.
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Telephone | 734-462-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | VG031529
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License Number State | MI
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