Individual
DR. KALYANI T. MOVVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15474 HAGGERTY RD, NORTHVILLE, MI 48170-4893
(248) 615-0889
(734) 404-5317
Mailing address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0871
(888) 220-6432
(630) 734-4715
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
MI
207RI0200X
Infectious Disease Physician
4301074529
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
462085510
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
KM074529
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/01/2006
Last updated
04/23/2013
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