Provider Demographics
NPI:1881915056
Name:KANDARP K. VORA, MD PC
Entity type:Organization
Organization Name:KANDARP K. VORA, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KANDARP
Authorized Official - Middle Name:K
Authorized Official - Last Name:VORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-426-9259
Mailing Address - Street 1:673 E CEDAR AVE
Mailing Address - Street 2:P.O. BOX 309
Mailing Address - City:GLADWIN
Mailing Address - State:MI
Mailing Address - Zip Code:48624-2215
Mailing Address - Country:US
Mailing Address - Phone:989-426-9259
Mailing Address - Fax:989-426-2341
Practice Address - Street 1:673 E CEDAR AVE
Practice Address - Street 2:
Practice Address - City:GLADWIN
Practice Address - State:MI
Practice Address - Zip Code:48624-2215
Practice Address - Country:US
Practice Address - Phone:989-426-9259
Practice Address - Fax:989-426-2341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI037407385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1678898Medicaid
MI0260217Medicare PIN