Provider Demographics
NPI:1124105341
Name:SANGHI, VINOD BIHARI (MD)
Entity type:Individual
Prefix:
First Name:VINOD
Middle Name:BIHARI
Last Name:SANGHI
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 1:6540 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2095
Mailing Address - Country:US
Mailing Address - Phone:313-381-2528
Mailing Address - Fax:313-381-3002
Practice Address - Street 1:6540 PARK AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2095
Practice Address - Country:US
Practice Address - Phone:313-381-2528
Practice Address - Fax:313-381-3002
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301034906207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101296508Medicaid
MI382215328OtherTAX ID
MI382215328OtherTAX ID
MI0821908Medicare PIN