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General NPI Number Information
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NPI Number | 1346614773
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Entity Type | Organization
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Legal Business Name | UPENDRA DHANJAL MD PLC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 4000 HIGHLAND RD STE 130
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City | WATERFORD
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State | MI
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Zip | 48328-2167
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Country | US
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Telephone | 248-681-7909
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Fax | 248-681-0455
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Provider Business Mailing Address
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Address Line | 4000 HIGHLAND RD STE 130
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City | WATERFORD
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State | MI
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Zip | 48328-2167
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Country | US
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Telephone | 248-681-7909
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Fax | 248-681-0455
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Authorized Official
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Title or Position | OWNER
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Name | UPENDRA DHANJAL
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Credential | MD
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Telephone | 248-661-3476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 4301075862
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 4301075862
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 4301075862
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License Number State | MI
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