Healthcare Provider Details

I. General information

NPI: 1548484702
Provider Name (Legal Business Name): ANURAG TIKARIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 COOLIDGE RD SUITE B
EAST LANSING MI
48823-6361
US

IV. Provider business mailing address

2601 COOLIDGE RD SUITE B
EAST LANSING MI
48823-6361
US

V. Phone/Fax

Practice location:
  • Phone: 517-913-4050
  • Fax: 517-333-0893
Mailing address:
  • Phone: 517-913-4050
  • Fax: 517-333-0893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number4301093979
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: