MEDICARE: DR. VASHALI BHARGAVA MD

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	207V00000X	Obstetrics & Gynecology Physician	4301075959	MI

General Provider Information

NPI Number	:	1730160383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VASHALI BHARGAVA MD

Provider Business Mailing Address
First Line	:	15500 LUNDY PKWY
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-2778
Country	:	US
Telephone Number	:	313-586-4906
Fax Number	:	313-792-7134

Provider Business Practice Location Address
First Line	:	18101 OAKWOOD BLVD
Second Line	:	OHMC, DEPARTMENT OF OB/GYN, LABOR AND DELIVERY
City	:	DEARBORN
State	:	MI
Zip	:	48124-4089
Country	:	US
Telephone Number	:	313-593-7500
Fax Number	:	313-593-8840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/13/2015

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