Provider Demographics
NPI:1750141727
Name:KOLADIYA, PURVESH ROHITKUMAR (MD)
Entity type:Individual
Prefix:
First Name:PURVESH
Middle Name:ROHITKUMAR
Last Name:KOLADIYA
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 1:5663 SILVER POND
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2061
Mailing Address - Country:US
Mailing Address - Phone:947-224-8974
Mailing Address - Fax:
Practice Address - Street 1:19460 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48223-1200
Practice Address - Country:US
Practice Address - Phone:313-497-3515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program