Healthcare Provider Details

I. General information

NPI: 1669384483
Provider Name (Legal Business Name): KUNDAN THIND PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

IV. Provider business mailing address

17234 ORCHARD RIDGE RD
NORTHVILLE MI
48168-4370
US

V. Phone/Fax

Practice location:
  • Phone: 734-292-5870
  • Fax:
Mailing address:
  • Phone: 734-292-5870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: