Provider Demographics
NPI:1578521118
Name:BIJLANI, SMITA (MD)
Entity Type:Individual
Prefix:
First Name:SMITA
Middle Name:
Last Name:BIJLANI
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 1:135 BARCLAY CIRCLE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2760
Mailing Address - Country:US
Mailing Address - Phone:248-853-7270
Mailing Address - Fax:248-853-7230
Practice Address - Street 1:135 BARCLAY CIRCLE
Practice Address - Street 2:SUITE 104
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2760
Practice Address - Country:US
Practice Address - Phone:248-853-7270
Practice Address - Fax:248-853-7230
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301055041207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110209552OtherRAILROAD MEDICARE
MI4513977OtherAETNA
MIG20979OtherHAP
MI4201310Medicaid
MI110209552OtherRAILROAD MEDICARE
MIG20979OtherHAP