Provider Demographics
NPI:1881809283
Name:KOTHARI, BINDIYA D (RPH)
Entity type:Individual
Prefix:MRS
First Name:BINDIYA
Middle Name:D
Last Name:KOTHARI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:BINDI
Other - Middle Name:
Other - Last Name:KOTHARI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:31190 KINGSLEY CT
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-1634
Mailing Address - Country:US
Mailing Address - Phone:248-669-4445
Mailing Address - Fax:586-751-1527
Practice Address - Street 1:2003 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-5642
Practice Address - Country:US
Practice Address - Phone:586-751-3600
Practice Address - Fax:586-751-1527
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIK360089143658OtherDRIVERS LICENSE NUMBER