Provider Demographics
NPI:1508617762
Name:GOVIL, DHRUVA (DO)
Entity Type:Individual
Prefix:
First Name:DHRUVA
Middle Name:
Last Name:GOVIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22250 PROVIDENCE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-6211
Mailing Address - Country:US
Mailing Address - Phone:248-849-3281
Mailing Address - Fax:248-849-5449
Practice Address - Street 1:22250 PROVIDENCE DR
Practice Address - Street 2:3PMB SUITE #301
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6211
Practice Address - Country:US
Practice Address - Phone:248-849-3281
Practice Address - Fax:248-849-5449
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program