Healthcare Provider Details

I. General information

NPI: 1326274473
Provider Name (Legal Business Name): SAKET ANAND SAXENA MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FORD PL # 2F51
DETROIT MI
48202-3450
US

IV. Provider business mailing address

16355 E JEFFERSON AVE
GROSSE POINTE PARK MI
48230-1458
US

V. Phone/Fax

Practice location:
  • Phone: 313-876-8319
  • Fax:
Mailing address:
  • Phone: 313-207-2374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number003433
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number4301106644
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number127733
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: