Provider Demographics
NPI:1881603975
Name:TOLIA, VASUNDHARA (MBBS)
Entity type:Individual
Prefix:DR
First Name:VASUNDHARA
Middle Name:
Last Name:TOLIA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:DR
Other - First Name:VASUNDHARA
Other - Middle Name:R
Other - Last Name:DOSHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:4304 COPPER CLIFF
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1922
Mailing Address - Country:US
Mailing Address - Phone:248-647-3243
Mailing Address - Fax:248-647-2227
Practice Address - Street 1:4304 COPPER CLIFF
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1922
Practice Address - Country:US
Practice Address - Phone:248-647-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI379742080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology