=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780976514
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VINOD B SANGHI MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2011
-----------------------------------------------------
Last Update Date | 05/12/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6540 PARK AVE
-----------------------------------------------------
City | ALLEN PARK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48101-2095
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-381-2528
-----------------------------------------------------
Fax | 313-381-3002
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6540 PARK AVE
-----------------------------------------------------
City | ALLEN PARK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48101-2095
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-381-2528
-----------------------------------------------------
Fax | 313-381-3002
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. VINOD B SANGHI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 313-381-2528
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | VS034906
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------