| Vicha Janviriya Mdpc | |
|
28750 San Carlos St Southfield MI 48076-2373 | |
| (313) 368-1600 | |
| Not Available |
| Full Name | Vicha Janviriya Mdpc |
|---|---|
| Speciality | Internal Medicine |
| Location | 28750 San Carlos St, Southfield, Michigan |
| Authorized Official Name and Position | Vicha Janviriya (OWNER) |
| Authorized Official Contact | 3133681600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vicha Janviriya Mdpc 28750 San Carlos St Southfield MI 48076-2373 Ph: (313) 368-1600 | Vicha Janviriya Mdpc 28750 San Carlos St Southfield MI 48076-2373 Ph: (313) 368-1600 |
| NPI Number | 1659507143 |
|---|---|
| Provider Enumeration Date | 06/10/2009 |
| Last Update Date | 06/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659507143 | NPI | - | NPPES |
| 102091256 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301032436 (Michigan) | Primary |
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