Tolia Pediatric Gi Center PC

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

4301037974 Issued in MI

Legal business name

TOLIA PEDIATRIC GI CENTER PC

Practice address

22250 Providence Dr
Suite 400
Southfield, MI 48075-4825

Phone

(248) 865-0030

Fax

(248) 865-0034

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Vasundhara Tolia, MD

Title

Owner/Physician

Phone

(248) 865-0030

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1972697688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-865-0030",
            "fax_number": "248-865-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-865-0030",
            "fax_number": "248-865-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOLIA PEDIATRIC GI CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "TOLIA",
        "authorized_official_first_name": "VASUNDHARA",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "248-865-0030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301037974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BCN",
            "identifier": "3506356221",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BCN",
            "identifier": "350F338410",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4909504",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodrigo Tobar Jr., DO
• Cady Tobias
• Tiba Mowafak Tokatly, D.D.S.
• Alisia Tolbert
• Amicah Desiray Tolbert
• Ketan Tolia, MD
• Kirit Tolia, MD
• Rhonda Toliver
• Chelsea Tolman, BCBA
• Montinique Tolson

• Pediatric Gastroenterology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Pediatric Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.