Mamidipaka, Vijaya
Mamidipaka, Vijaya is an individual health care provider with primary practice located at 47500 Ffve Mile Road , Plymouth MI 48170. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mamidipaka, Vijaya can be contacted via phone (734) 459-7400.Contact Information
Primary practice address
47500 Ffve Mile Road
Plymouth MI 48170
Phone: (734) 459-7400
Fax: (734) 459-7403
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4301082641 | Michigan |
Profile Details
| NPI number | 1295770394 |
|---|---|
| LBN Legal business name | Mamidipaka, Vijaya |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Apr 29th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295770394 | NPPES |
| Massachusetts | Other | OH24978 | BLUE CROSS BLUE SHIELD MI |
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