VIJAY K MITTAL (NPI# 1073615282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073615282 |
| Entity Type | Individual |
| Full Name | VIJAY K MITTAL |
| Credential | MD |
| Practice Address |
22250 Providence Drive Suite 703a Southfield MI 48075 |
| Practice Telephone | 2488495862 |
| Practice Fax Number | 2488498117 |
| Mailing Telephone | 2488495862 |
| Mailing Fax Number | 2488498117 |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | VM037030 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS | 0208212582 | 01 |
| BCN | P46853 | 01 | |
| MI | 2114520 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982990156 | Vijay Mittal | Internal Medicine | 2002 Holcombe Blvd, Houston, TX 77030-4211 | 2011-06-25 |
| 1821026022 | Vijay K Mittal | Internal Medicine | 3310 Sw 34th St, Ocala, FL 34474-7422 | 2006-06-28 |
| Street Address |
22250 PROVIDENCE DRIVE SUITE 703A |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477557734 | Michelle Baker | Physician Assistant | 22250 Providence Drive, 5th Flooor, Southfield, MI 48075 | 2005-06-02 |
| 1154949535 | Cory Xavier Cole | Internal Medicine | 22250 Providence Drive, Academic Im Pmb Suite #301, Southfield, MI 48075 | 2020-07-11 |
| 1235754813 | Harvey Sekhon | Student in an Organized Health Care Education/Training Program | 22250 Providence Drive, 3 Pmb #301, Southfield, MI 48075-4818 | 2020-06-10 |
| 1730703810 | Anudeep Kommineni | Internal Medicine | 22250 Providence Drive, 3pmb Suite 301, Southfield, MI 48075 | 2020-06-03 |
| 1144844564 | Elton Yichao Li | Student in an Organized Health Care Education/Training Program | 22250 Providence Drive, Suite #557, Southfield, MI 48075-4818 | 2020-06-01 |
| 1699331496 | Alexander Zayid | Student in an Organized Health Care Education/Training Program | 22250 Providence Drive, Suite #5577, Southfield, MI 48075-4818 | 2019-05-16 |
| 1528624798 | Karan Singh Sekhon | Student in an Organized Health Care Education/Training Program | 22250 Providence Drive, Suite #557, Southfield, MI 48075-4818 | 2019-05-14 |
| 1164087888 | Kathleen Jeanne Marie Harnois | Student in an Organized Health Care Education/Training Program | 22250 Providence Drive, Suite #703a, Southfield, MI 48075-4818 | 2019-05-08 |
| 1912561119 | Elise Jongeun Yoon | Student in an Organized Health Care Education/Training Program | 22250 Providence Drive, Suite #601, Southfield, MI 48075-4818 | 2019-04-24 |
| 1497319511 | Dexter Tyler Powell | Student in an Organized Health Care Education/Training Program | 22250 Providence Drive, Suite #401, Southfield, MI 48075-4818 | 2019-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724101 | Alec Jerry Raniwsky | Surgery | 22250 Providence Drive 7pmb Suite #703a, Southfield, MI 48075-4825 | 2020-06-12 |
| 1881898716 | Lubna Noreen Suleman | Surgery | 16001 W Nine Mile Rd, Southfield, MI 48075 | 2007-06-13 |
| 1336358522 | Jerome William Cooper | Surgery | 23625 Northwestern Hwy, Southfield, MI 48075-7711 | 2007-05-22 |
| 1154391381 | Steven Hendrick | Surgery | 29080 Inkster Rd Ste 250, Southfield, MI 48034-1057 | 2006-01-23 |
| 1326036849 | Thomas M Flake Jr. | Surgery | 23077 Greenfield Rd, Suite 445, Southfield, MI 48075-3709 | 2005-10-10 |
| 1063037877 | Carly Beth Young | Surgery | 22250 Providence Dr Ste 703a, Southfield, MI 48075-6215 | 2020-06-08 |
| 1861016131 | Destiny Aighobahi | Surgery | 16001 W 9 Mile Rd Ofc, Southfield, MI 48075-4818 | 2020-06-03 |
| 1386268035 | Denas Andrijauskis | Surgery | 22250 Providence Dr, Southfield, MI 48075-4825 | 2020-05-28 |
| 1902460132 | Madan Mohan Reddy Paluru | Surgery | 22250 Providence Drive, Suite #703a, Southfield, MI 48075-4818 | 2019-04-23 |
| 1427611748 | Keith Peter Ameyaw | Surgery | 16001 W 9 Mile Rd Ofc, Southfield, MI 48075-4818 | 2019-04-22 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.