Provider Demographics
NPI:1932181559
Name:GARG, AMIT KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:KUMAR
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:43211 DALCOMA DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6309
Mailing Address - Country:US
Mailing Address - Phone:586-228-2400
Mailing Address - Fax:586-228-2517
Practice Address - Street 1:43211 DALCOMA DR
Practice Address - Street 2:SUITE 9
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6309
Practice Address - Country:US
Practice Address - Phone:586-228-2400
Practice Address - Fax:586-228-2517
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301039127207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
B44766Medicare UPIN