Individual provider Active NPI

Abhijit Datta

  • Pharmacist
  • Canton, MI
National Provider Identifier
1871951293
Registry record updated Jan 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302042527 Issued in MI
Practice address
5634 Fordham Cir Apt 204
Canton, MI 48187-3353
Phone
(734) 981-1707
NPI assigned
Jan 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302042527 MI Primary

Addresses

Primary practice location

5634 Fordham Cir Apt 204
Canton, MI 48187-3353

Mailing address

5634 Fordham Cir Apt 204
Canton, MI 48187-3353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5302042527MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454112000000",
    "number": "1871951293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5634 FORDHAM CIR APT 204",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5634 FORDHAM CIR APT 204",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873353",
            "telephone_number": "734-981-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTA",
        "first_name": "ABHIJIT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-30",
        "last_updated": "2016-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302042527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.