Individual
VONDA DOUGLAS-NIKITIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-5000
Mailing address
3601 W 13 MILE RD, 400-FSC/PCS, ROYAL OAK, MI 48073-6712
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
4301060103
MI
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
4301060103
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220F349850
BCBSM
MI
05
—
4689349
—
MI
Enumeration date
03/22/2006
Last updated
10/02/2008
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