Individual
BAVITHIRA ABIVARSHIA YEBOAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22646 E 9 MILE RD STE A, SAINT CLAIR SHORES, MI 48080-1951
(586) 498-4800
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036148068
IL
207Q00000X
Family Medicine Physician
Primary
4301509904
MI
Other
Enumeration date
07/15/2016
Last updated
08/27/2024
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