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Organization
VIMLA K GARG MD PC
Active
Organization
VIMLA K GARG MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIMLA GARG MD (PRESIDENT)
(734) 560-6498
Entity
Organization
Contact information
Practice address
8400 PELHAM RD, TAYLOR, MI 48180-3834
(734) 560-6498
Mailing address
25 KREGER DR, WYANDOTTE, MI 48192-6258
(734) 560-6498
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301056332
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0808266521
BCBS PROVIDER #
—
01
—
0M56100
MEDICARE PROVIDER NUMBER
MI
01
—
1992741607
NPI
—
05
—
4163443
—
MI
01
—
4301056332
MI LICENSE #
MI
Enumeration date
04/06/2010
Last updated
04/06/2010
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