Provider Demographics
NPI:1912944919
Name:BAWLE, ERAWATI VISHWAS (MD)
Entity Type:Individual
Prefix:
First Name:ERAWATI
Middle Name:VISHWAS
Last Name:BAWLE
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3901 BEAUBIEN,
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF MICHIGAN, DIV OF GENETICS.
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2061
Mailing Address - Country:US
Mailing Address - Phone:313-745-4513
Mailing Address - Fax:313-745-4827
Practice Address - Street 1:3901 BEAUBIEN BLVD,
Practice Address - Street 2:CHILDREN'S HOSPITAL OF MICHIGAN, DIV OF GENETICS.
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2061
Practice Address - Country:US
Practice Address - Phone:313-745-4513
Practice Address - Fax:313-745-4827
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301933771207SG0201X
MI4301033771208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics