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General NPI Number Information
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NPI Number | 1568043834
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Entity Type | Individual
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Provider Name | SIMARJEET PURI MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 26750 PROVIDENCE PKWY STE 200
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City | NOVI
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State | MI
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Zip | 48374-1212
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Country | US
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Telephone | 866-974-2673
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Fax |
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Provider Business Mailing Address
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Address Line | 16001 W 9 MILE RD FL 4
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4818
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Country | US
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Telephone | 248-849-2513
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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