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General NPI Number Information
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NPI Number | 1437685856
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Entity Type | Organization
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Legal Business Name | INDEPENDENT BEHAVIORAL HEALTH GROUP
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 4413 CORUNNA RD
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City | FLINT
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State | MI
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Zip | 48532-4321
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Country | US
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Telephone | 810-733-5733
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Fax |
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Provider Business Mailing Address
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Address Line | 4413 CORUNNA RD
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City | FLINT
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State | MI
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Zip | 48532-4321
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTORE
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Name | NIKHIL VORA
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Credential | MD
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Telephone | 810-733-5735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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