Provider Demographics
NPI:1689632853
Name:DOSHI, NITIN C (MD)
Entity Type:Individual
Prefix:DR
First Name:NITIN
Middle Name:C
Last Name:DOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44555 WOODWARD AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5031
Mailing Address - Country:US
Mailing Address - Phone:248-338-2420
Mailing Address - Fax:248-858-3888
Practice Address - Street 1:44555 WOODWARD AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5031
Practice Address - Country:US
Practice Address - Phone:248-338-2420
Practice Address - Fax:248-858-3888
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301035477207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1956215Medicaid
MI0606317291OtherBLUE CROSS
MI1956215Medicaid
MI0606317291OtherBLUE CROSS