MEDICARE: VITALITY HEALTH PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083B0002X	Obesity Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number	:	1083447551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITALITY HEALTH PLLC

Provider Business Mailing Address
First Line	:	432 BLOSSOM DR
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-6024
Country	:	US
Telephone Number	:	248-722-3736
Fax Number	:

Provider Business Practice Location Address
First Line	:	432 BLOSSOM DR
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-6024
Country	:	US
Telephone Number	:	248-722-3736
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SHAHNIWAZ LABANA
Credential	:	MD, MBA
Telephone Number	:	248-722-3736

Provider Enumeration Date	:	08/21/2024
Last Update Date	:	08/21/2024

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