Healthcare Provider Details

I. General information

NPI: 1649975897
Provider Name (Legal Business Name): SARAH KOSHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MEDICAL CENTER DR D2204 MPB, SPC 5718
ANN ARBOR MI
48109-5718
US

IV. Provider business mailing address

1500 E MEDICAL CENTER DR D2204 MPB, SPC 5718
ANN ARBOR MI
48109-5718
US

V. Phone/Fax

Practice location:
  • Phone: 734-647-8100
  • Fax:
Mailing address:
  • Phone: 734-647-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number4301516435
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: