Basic Information
| Provider Information | |||||||||
| NPI: | 1518191865 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MULAY | ||||||||
| FirstName: | ANJALI | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MBBS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 KIRTS BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488246623 | ||||||||
| FaxNumber: | 8556186655 | ||||||||
| Practice Location | |||||||||
| Address1: | 4545 FULLER DR STE 325 | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750386530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728705511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2009 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 54302 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.