Provider Demographics
NPI:1366628703
Name:VIDHOLIA, GARGI (MD)
Entity Type:Individual
Prefix:
First Name:GARGI
Middle Name:
Last Name:VIDHOLIA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:159 KERCHEVAL AVE
Mailing Address - Street 2:THE ASSESSMENT CENTER FOR SENIORS, HENRY FORD COTTAGE
Mailing Address - City:GROSSE POINTE FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-3610
Mailing Address - Country:US
Mailing Address - Phone:248-835-6311
Mailing Address - Fax:313-640-2548
Practice Address - Street 1:159 KERCHEVAL AVE
Practice Address - Street 2:THE ASSESSMENT CENTER FOR SENIORS, HENRY FORD COTTAGE
Practice Address - City:GROSSE POINTE FARMS
Practice Address - State:MI
Practice Address - Zip Code:48236-3610
Practice Address - Country:US
Practice Address - Phone:313-640-2277
Practice Address - Fax:313-640-2548
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2013-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301089848207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine