Provider Demographics
NPI:1114069499
Name:AHOOJA, VINEETA (MD)
Entity Type:Individual
Prefix:
First Name:VINEETA
Middle Name:
Last Name:AHOOJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2936
Mailing Address - Country:US
Mailing Address - Phone:810-733-0790
Mailing Address - Fax:810-733-1817
Practice Address - Street 1:4040 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2936
Practice Address - Country:US
Practice Address - Phone:810-733-0790
Practice Address - Fax:810-733-1817
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076842207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4977863Medicaid
MI4977890Medicaid
1114069499OtherINDIVIDUAL NPI
MI4978190Medicaid
I70949Medicare UPIN
MI4978190Medicaid
MI4977863Medicaid