Provider Demographics
NPI:1346435963
Name:A BALA SETTY MD PC
Entity Type:Organization
Organization Name:A BALA SETTY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAIN DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:A BALA
Authorized Official - Middle Name:
Authorized Official - Last Name:SETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:734-729-4343
Mailing Address - Street 1:33116 PALMER RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-5524
Mailing Address - Country:US
Mailing Address - Phone:734-729-4343
Mailing Address - Fax:734-729-0222
Practice Address - Street 1:33116 PALMER RD
Practice Address - Street 2:SUITE D
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5524
Practice Address - Country:US
Practice Address - Phone:734-729-4343
Practice Address - Fax:734-729-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS035467305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDH2316OtherMEDICARE RAILROAD
MI2928321OtherDME
MI2928321OtherDME
MIF02009Medicare UPIN