Individual
GAITI ARA BAKHSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
10000 TELEGRAPH ROAD,, EMERGENCY MEDICINE DEPARTMENT, TAYLOR, MI 48180-3330
(313) 295-5007
(313) 295-6725
Mailing address
38935 ANN ARBOR ROAD, CREDENTIALING/PAYER CONTRACTING SERVICES, LIVONIA, MI 48150-3397
(734) 632-0175
(734) 632-0182
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0102203148
VA
207P00000X
Emergency Medicine Physician
Primary
5101011604
MI
207P00000X
Emergency Medicine Physician
OS016514
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11271278
CAQH
—
Enumeration date
05/26/2006
Last updated
09/05/2013
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