Individual
MRS. NEERAL SUBHASH VISHWANATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3601 W 13 MILE RD STE EC, ROYAL OAK, MI 48073-6712
(248) 898-0575
(248) 898-4671
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
014214-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03499483
—
NY
Enumeration date
04/21/2009
Last updated
07/25/2022
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