Provider Demographics
NPI:1821392820
Name:DUGGAL, RISHI (MD)
Entity Type:Individual
Prefix:
First Name:RISHI
Middle Name:
Last Name:DUGGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1920 AVENUE ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIGHT'S GROVE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N0N1C0
Mailing Address - Country:CA
Mailing Address - Phone:519-908-9129
Mailing Address - Fax:
Practice Address - Street 1:1530 PINE GROVE AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3370
Practice Address - Country:US
Practice Address - Phone:810-985-0029
Practice Address - Fax:810-985-0032
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010913682085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology