Individual
DR. SHIVANI CHOUDHARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8203 S SAGINAW ST, GRAND BLANC, MI 48439-2434
(810) 875-0566
Mailing address
8203 S SAGINAW ST, GRAND BLANC, MI 48439-2434
(810) 875-0566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301086642
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3502514032
BLUE CROSS BLUE SHIELD OF MICHIGAN PROVIDER ID#
MI
01
—
OB57611
BLUE CROSS BLUE SHIELD OF MICHIGAN - PEDIATRIC GROUP
MI
Enumeration date
08/23/2007
Last updated
09/28/2015
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