Healthcare Provider Details

I. General information

NPI: 1144077991
Provider Name (Legal Business Name): ANEESH HEHR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MEDICAL CENTER DRIVE UH SOUTH F-6245
ANN ARBOR MI
48109
US

IV. Provider business mailing address

1500 E MEDICAL CENTER DRIVE UH SOUTH F-6245
ANN ARBOR MI
48109
US

V. Phone/Fax

Practice location:
  • Phone: 734-764-4231
  • Fax:
Mailing address:
  • Phone: 734-764-4231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351052396
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: