Provider Demographics
NPI:1831611870
Name:VINAY K MALVIYA MD PC
Entity type:Organization
Organization Name:VINAY K MALVIYA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VINAY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MALVIYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-465-5104
Mailing Address - Street 1:4610 CIMARRON DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2216
Mailing Address - Country:US
Mailing Address - Phone:248-539-3956
Mailing Address - Fax:248-539-3954
Practice Address - Street 1:26850 PROVIDENCE PKWY STE 530
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1268
Practice Address - Country:US
Practice Address - Phone:248-465-5104
Practice Address - Fax:248-465-5103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046543207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty