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General NPI Number Information
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NPI Number | 1891910105
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Entity Type | Individual
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Provider Name | ROBERT SUDHIR VAIDYA D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 1194 OAK VALLEY DR STE 80B
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City | ANN ARBOR
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State | MI
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Zip | 48108-8942
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Country | US
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Telephone | 734-975-5000
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Fax | 734-975-0376
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Provider Business Mailing Address
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Address Line | PO BOX 40412
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City | BELFAST
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State | ME
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Zip | 04915-1255
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Country | US
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Telephone | 734-975-5000
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Fax | 734-975-0376
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5101016730
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License Number State | MI
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