Provider Demographics
NPI:1457821555
Name:ANIYALI, CHIRAGBHAI NARENDRABHAI
Entity Type:Individual
Prefix:MR
First Name:CHIRAGBHAI
Middle Name:NARENDRABHAI
Last Name:ANIYALI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48778 WINDMILL CIR E
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-4917
Mailing Address - Country:US
Mailing Address - Phone:313-377-7220
Mailing Address - Fax:
Practice Address - Street 1:48778 WINDMILL CIR E
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-4917
Practice Address - Country:US
Practice Address - Phone:313-377-7220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501014927Medicaid