Provider Demographics
NPI:1851972707
Name:PUROHIT, NEELAY DIVYESH (MD)
Entity Type:Individual
Prefix:
First Name:NEELAY
Middle Name:DIVYESH
Last Name:PUROHIT
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 1:3890 CLEARVIEW ST NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-1386
Mailing Address - Country:US
Mailing Address - Phone:812-249-3802
Mailing Address - Fax:
Practice Address - Street 1:25 MICHIGAN ST NE STE 2100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2526
Practice Address - Country:US
Practice Address - Phone:616-391-3777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program