Provider Demographics
NPI:1932168408
Name:DOSHI, DEVANG RATIKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:DEVANG
Middle Name:RATIKUMAR
Last Name:DOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-3507
Mailing Address - Country:US
Mailing Address - Phone:248-588-2222
Mailing Address - Fax:248-577-9999
Practice Address - Street 1:3216 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-588-2222
Practice Address - Fax:248-577-9999
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301068779207K00000X, 207KA0200X, 2080P0214X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1932168408Medicaid
MI350F361320OtherBCBSM
MI0F36132108Medicare PIN