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General NPI Number Information
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NPI Number | 1780909473
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Entity Type | Organization
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Legal Business Name | VIMLA K GARG MD PC
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 8400 PELHAM RD
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City | TAYLOR
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State | MI
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Zip | 48180-3834
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Country | US
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Telephone | 734-560-6498
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Fax |
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Provider Business Mailing Address
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Address Line | 25 KREGER DR
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City | WYANDOTTE
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State | MI
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Zip | 48192-6258
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Country | US
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Telephone | 734-560-6498
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIMLA GARG
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Credential | MD
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Telephone | 734-560-6498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301056332
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License Number State | MI
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