Provider Demographics
NPI:1053571034
Name:AGGARWAL, ANJU GOYAL (MD)
Entity type:Individual
Prefix:DR
First Name:ANJU
Middle Name:GOYAL
Last Name:AGGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 TELEGRAPH RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3376
Mailing Address - Country:US
Mailing Address - Phone:313-228-5341
Mailing Address - Fax:
Practice Address - Street 1:10501 TELEGRAPH RD STE 102
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3376
Practice Address - Country:US
Practice Address - Phone:313-228-5341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092004207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology