Healthcare Provider Details

I. General information

NPI: 1740774348
Provider Name (Legal Business Name): GURBAKSH KAUR ESCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 15 MILE RD
STERLING HEIGHTS MI
48310-5353
US

IV. Provider business mailing address

3500 15 MILE RD
STERLING HEIGHTS MI
48310-5353
US

V. Phone/Fax

Practice location:
  • Phone: 586-977-9300
  • Fax: 586-977-9300
Mailing address:
  • Phone: 586-977-9300
  • Fax: 586-977-9300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301505067
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: