Healthcare Provider Details

I. General information

NPI: 1861549677
Provider Name (Legal Business Name): ANITA KUMAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HENRY FORD HEALTH SYSTEM 8600 CHICAGO ROAD SOUTH
WARREN MI
48093
US

IV. Provider business mailing address

HENRY FORD HEALTH SYSTEM 8600 CHICAGO ROAD SOUTH
WARREN MI
48093
US

V. Phone/Fax

Practice location:
  • Phone: 586-826-3300
  • Fax: 586-826-3326
Mailing address:
  • Phone: 586-826-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301037677
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: