Healthcare Provider Details

I. General information

NPI: 1639161334
Provider Name (Legal Business Name): ANJANA M BARAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 CORPORATE OFFICE DR STE 100
MILFORD MI
48381-3199
US

IV. Provider business mailing address

3168 SOLUTIONS CTR # 773168
CHICAGO IL
60677-3001
US

V. Phone/Fax

Practice location:
  • Phone: 248-684-6155
  • Fax: 248-684-6154
Mailing address:
  • Phone: 248-680-8000
  • Fax: 248-680-8030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301065766
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: