Individual
MR. VICHA JANVIRIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20905 GREENFIELD RD, SUITE 603M, SOUTHFIELD, MI 48075-5360
(248) 268-4464
(248) 268-4465
Mailing address
28750 SAN CARLOS, SOUTHFIELD, MI 48076
(248) 352-3297
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301032436
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2091256
—
MI
Enumeration date
10/16/2006
Last updated
07/25/2014
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