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General NPI Number Information
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NPI Number | 1871957878
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Entity Type | Organization
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Legal Business Name | SYNERGY MEDICAL PC
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 9216 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48150-4036
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Country | US
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Telephone | 734-427-3500
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Fax | 734-427-9234
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Provider Business Mailing Address
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Address Line | 9216 MIDDLEBELT RD
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City | LIVONIA
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State | MI
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Zip | 48150-4036
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Country | US
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Telephone | 734-427-3500
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Fax | 734-437-9234
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Authorized Official
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Title or Position | CEO/MD
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Name | MRS. HETEL A GANDHI
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Credential | M.D.
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Telephone | 248-252-4714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301077074
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License Number State | MI
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