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General NPI Number Information
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NPI Number | 1821264227
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Entity Type | Organization
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Legal Business Name | VINAYKMALVIYA MD PC
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 05/26/2011
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Provider Practice Location Address
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Address Line | 22301 FOSTER WINTER DR 3RD FLOOR
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3707
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Country | US
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Telephone | 248-849-8140
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Fax | 248-849-8108
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Provider Business Mailing Address
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Address Line | 22301 FOSTER WINTER DR FL 3
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3707
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Country | US
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Telephone | 248-849-8140
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Fax | 248-849-8108
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Authorized Official
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Title or Position | OWNER
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Name | VINAY KUMAR MALVIYA
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Credential | MD
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Telephone | 248-849-8140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 4301046543
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 4301046543
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License Number State | MI
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