Provider Demographics
NPI:1932583671
Name:ADABALA, NIVEDITA P (MD)
Entity Type:Individual
Prefix:DR
First Name:NIVEDITA
Middle Name:P
Last Name:ADABALA
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1634 BLOOMFIELD PLACE DR
Mailing Address - Street 2:APT 227A
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302
Mailing Address - Country:US
Mailing Address - Phone:316-821-7364
Mailing Address - Fax:
Practice Address - Street 1:44405 WOODWARD AVENUE
Practice Address - Street 2:H-23
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:316-821-7364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301107208207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine