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General NPI Number Information
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NPI Number | 1760745780
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Entity Type | Organization
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Legal Business Name | MUKESH LATHIA MD, PLLC
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 4404 QUAIL HOLLOW CT
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City | SAGINAW
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State | MI
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Zip | 48603-8622
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Country | US
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Telephone | 989-249-7662
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Fax |
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Provider Business Mailing Address
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Address Line | 4404 QUAIL HOLLOW CT
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City | SAGINAW
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State | MI
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Zip | 48603-8622
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Country | US
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Telephone | 989-249-7662
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MUKESH LATHIA
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Credential | MD
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Telephone | 989-249-7662
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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 | ML073076
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License Number State | MI
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