Provider Demographics
NPI:1174618375
Name:SANGAL, R BART (MD)
Entity type:Individual
Prefix:DR
First Name:R
Middle Name:BART
Last Name:SANGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44344 DEQUINDRE RD STE 360
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1041
Mailing Address - Country:US
Mailing Address - Phone:586-254-0707
Mailing Address - Fax:586-254-7207
Practice Address - Street 1:44344 DEQUINDRE RD STE 360
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1041
Practice Address - Country:US
Practice Address - Phone:586-254-0707
Practice Address - Fax:586-254-7207
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI462112084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1305003981OtherBLUE CARE NETWORK
MI1305003981OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI1790771Medicaid
MIA73679OtherHEALTH ALLIANCE PLAN
MIP56550001Medicare PIN
MI1790771Medicaid