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Organization
VICHA JANVIRIYA MDPC
Active
Organization
VICHA JANVIRIYA MDPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICHA JANVIRIYA MD (OWNER)
(313) 368-1600
Entity
Organization
Contact information
Practice address
28750 SAN CARLOS ST, SOUTHFIELD, MI 48076-2373
(313) 368-1600
Mailing address
28750 SAN CARLOS ST, SOUTHFIELD, MI 48076-2373
(313) 368-1600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301032436
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102091256
—
MI
Enumeration date
06/10/2009
Last updated
06/10/2009
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