Organization
PEDIAKARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVYANI GUPTA MD (DIRECTOR)
(248) 808-1299
Entity
Organization
Contact information
Practice address
35240 NANKIN BLVD, WESTLAND, MI 48185-7218
(734) 427-3636
(734) 427-1483
Mailing address
3859 FADI DR, TROY, MI 48084-1584
(248) 808-1299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
02/08/2019
Last updated
09/30/2020
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