Provider Demographics
NPI:1457608200
Name:MALVIYA, MEENAL (MD)
Entity type:Individual
Prefix:MRS
First Name:MEENAL
Middle Name:
Last Name:MALVIYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MEENAL
Other - Middle Name:
Other - Last Name:TIWARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:22255 GREENFIELD RD STE 410
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3730
Mailing Address - Country:US
Mailing Address - Phone:248-849-3281
Mailing Address - Fax:248-849-5449
Practice Address - Street 1:22255 GREENFIELD RD STE 410
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3730
Practice Address - Country:US
Practice Address - Phone:248-849-3281
Practice Address - Fax:248-849-5449
Is Sole Proprietor?:No
Enumeration Date:2012-08-11
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301503916207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease