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Organization
XAVIER MD PC
Active
Organization
XAVIER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA AMUDHA XAVIER (PRESIDENT)
(248) 621-9200
Entity
Organization
Contact information
Practice address
31500 TELEGRAPH RD STE 115, BINGHAM FARMS, MI 48025-4302
(248) 621-9200
Mailing address
6632 TELEGRAPH RD, 204, BLOOMFIELD, MI 48301-3012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
2084V0102X
Vascular Neurology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699124503
NPI
—
Enumeration date
08/11/2016
Last updated
06/08/2020
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