Individual
KETAN TOLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22255 GREENFIELD, 400, SOUTHFIELD, MI 48075
(248) 465-4010
(248) 465-4011
Mailing address
26850 PROVIDENCE PKWY, PMOB#200, NOVI, MI 48374-1213
(248) 465-3144
(248) 465-3146
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301054022
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
447791910
—
MI
Enumeration date
08/02/2005
Last updated
08/13/2013
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