Individual
SWEETY AJAY SRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301089092
MI
2080P0210X
Pediatric Nephrology Physician
4301089092
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-609-209-2
ECFMG
—
01
—
382406558
HAMILTON TAX ID
MI
05
—
5175322
—
MI
Enumeration date
05/04/2007
Last updated
11/01/2021
Update your record
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