Provider Demographics
NPI:1821264227
Name:VINAYKMALVIYA MD PC
Entity Type:Organization
Organization Name:VINAYKMALVIYA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINAY
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:MALVIYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-849-8140
Mailing Address - Street 1:22301 FOSTER WINTER DR FL 3
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3707
Mailing Address - Country:US
Mailing Address - Phone:248-849-8140
Mailing Address - Fax:248-849-8108
Practice Address - Street 1:22301 FOSTER WINTER DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3707
Practice Address - Country:US
Practice Address - Phone:248-849-8140
Practice Address - Fax:248-849-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046543207VG0400X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0631294OtherBCBSM
MI1184623514Medicaid
1184623514OtherNPI
MI0631294OtherBCBSM
MIB46398Medicare UPIN