Healthcare Provider Details

I. General information

NPI: 1922098235
Provider Name (Legal Business Name): ANNE M ERBEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 E WATTLES RD STE 300
TROY MI
48085-7008
US

IV. Provider business mailing address

2950 E WATTLES RD STE 300
TROY MI
48085-7008
US

V. Phone/Fax

Practice location:
  • Phone: 248-524-2121
  • Fax: 248-524-2035
Mailing address:
  • Phone: 248-524-2121
  • Fax: 248-524-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number4301055950
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: