Basic Information
| Provider Information | |||||||||
| NPI: | 1710924204 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DHABUWALA | ||||||||
| FirstName: | CHIRPRIYA | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 673671 | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482673671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107205715 | ||||||||
| FaxNumber: | 8107320891 | ||||||||
| Practice Location | |||||||||
| Address1: | 30671 STEPHENSON HWY | ||||||||
| Address2: | |||||||||
| City: | MADISON HTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480711635 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137453553 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 07/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 4301039423 | MI | Y | Allopathic & Osteopathic Physicians | Urology | 208800000X | 042.0013197 | VT | N | Allopathic & Osteopathic Physicians | Urology |
No ID Information.