| Dr Shylaja Gontina-khatiwala, MD | |
|
9600 N Rushton Rd, South Lyon, MI 48178-8849 | |
| (248) 721-1510 | |
| Not Available |
| Full Name | Dr Shylaja Gontina-khatiwala |
|---|---|
| Gender | Female |
| Speciality | Family Medicine - Addiction Medicine |
| Location | 9600 N Rushton Rd, South Lyon, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205836137 | NPI | - | NPPES |
| 11438804 | Other | MI | CAQH |
| 1205836137 | Other | MI | BCBS TYPE 1 (IND) NPI # |
| 5315052867 | Other | MI | CDS # |
| 4301076421 | Other | MI | STATE LICENSE # |
| P37000001 | Other | MI | MEDICARE IND PIN # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301076421 (Michigan) | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | 4301076421 (Michigan) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shylaja Gontina-khatiwala, MD 9600 N Rushton Rd, South Lyon, MI 48178-8849 Ph: (248) 721-1510 | Dr Shylaja Gontina-khatiwala, MD 9600 N Rushton Rd, South Lyon, MI 48178-8849 Ph: (248) 721-1510 |
Dr. Steve Sungmin Kim, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 210 N Lafayette St, South Lyon, MI 48178 Phone: 248-437-1744 | |
Promita Roychoudhury, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 210 N Lafayette, South Lyon, MI 48178 Phone: 248-437-1744 Fax: 248-446-2420 | |
Dr. Kyle M Samyn, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 22024 Pontiac Trl, South Lyon, MI 48178 Phone: 248-437-2525 | |
Dr. Michael Samir Matar, M.D Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 210 N Lafayette Street, South Lyon, MI 48178 Phone: 248-437-1744 | |
Lauren H. Groskaufmanis, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 210 N Lafayette St, South Lyon, MI 48178 Phone: 248-437-1744 Fax: 248-437-3245 | |
Cherolee Rickey Trembath, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 210 N Lafayette St, South Lyon, MI 48178 Phone: 248-437-1744 Fax: 248-437-3245 |