Individual
GAURAV BHALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4190 24TH AVE STE 201, FORT GRATIOT, MI 48059-3884
(810) 216-4200
Mailing address
4190 24TH AVE STE 201, FORT GRATIOT, MI 48059-3884
(810) 216-4200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301100838
MI
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301100838
MI
Other
Enumeration date
07/09/2012
Last updated
07/21/2022
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