Provider Demographics
NPI:1972528818
Name:JARODIYA, BABUBHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:BABUBHAI
Middle Name:
Last Name:JARODIYA
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 1:15130 LEVAN RD STE 30
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5027
Mailing Address - Country:US
Mailing Address - Phone:734-779-2101
Mailing Address - Fax:734-779-2121
Practice Address - Street 1:15130 LEVAN RD STE 30
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5027
Practice Address - Country:US
Practice Address - Phone:734-779-2101
Practice Address - Fax:734-779-2121
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBJ053911207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF14642Medicare UPIN
MI0M80530005Medicare PIN