Provider Demographics
NPI:1083818314
Name:MANVEEN SALUJA MD PLLC
Entity Type:Organization
Organization Name:MANVEEN SALUJA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANVEEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SALUJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-677-4700
Mailing Address - Street 1:1380 COOLIDGE HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-7069
Mailing Address - Country:US
Mailing Address - Phone:248-677-4700
Mailing Address - Fax:248-655-0144
Practice Address - Street 1:1380 COOLIDGE HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7069
Practice Address - Country:US
Practice Address - Phone:248-677-4700
Practice Address - Fax:248-655-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056405207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1106336322OtherBLUE CROSS BLUE SHEILD
MIG16143Medicare UPIN
MI0P22520001Medicare PIN