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General NPI Number Information
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NPI Number | 1205277811
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Entity Type | Individual
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Provider Name | KARAN MATHUR M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 4160 JOHN R ST STE 615
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City | DETROIT
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State | MI
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Zip | 48201-2022
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Country | US
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Telephone | 313-745-4195
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Fax |
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Provider Business Mailing Address
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Address Line | 400 MACK AVE
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City | DETROIT
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State | MI
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Zip | 48201-2136
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301501018
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License Number State | MI
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