Basic Information
Provider Information
NPI: 1063622454
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VANSADIA
FirstName: ANUPAMA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 54146 DEER RIDGE CT
Address2:  
City: ROCHESTER HILLS
State: MI
PostalCode: 483077300
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 6700 N ROCHESTER RD STE 210
Address2:  
City: ROCHESTER HILLS
State: MI
PostalCode: 483064378
CountryCode: US
TelephoneNumber: 2486501534
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/23/2007
LastUpdateDate: 07/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VX0000X430108095MIY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics

No ID Information.


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