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General NPI Number Information
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NPI Number | 1740570811
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Entity Type | Organization
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Legal Business Name | VINAYA K. GAVINI MDPC
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 8550 N SILVERY LN SUITE 101
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-4510
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Country | US
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Telephone | 313-730-7007
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Fax | 313-730-7002
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Provider Business Mailing Address
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Address Line | 8550 N SILVERY LN SUITE 101
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-4510
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Country | US
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Telephone | 313-730-7007
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Fax | 313-730-7002
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VINAYA KUMAR GAVINI
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Credential | M.D.
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Telephone | 313-595-8304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301037182
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License Number State | MI
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