Provider Demographics
NPI:1306933908
Name:BANSIL, CHYAWAN KUMAR (PT, PHD)
Entity type:Individual
Prefix:DR
First Name:CHYAWAN
Middle Name:KUMAR
Last Name:BANSIL
Suffix:
Gender:M
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28959 AUGUSTA
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-4822
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:248-444-8339
Practice Address - Street 1:28959 AUGUSTA
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-4822
Practice Address - Country:US
Practice Address - Phone:248-299-0030
Practice Address - Fax:248-444-8339
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N49980Medicare ID - Type Unspecified
MI0N58820Medicare ID - Type Unspecified
MI0F35891OtherPHYSICAL THERAPIST