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General NPI Number Information
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NPI Number | 1881721165
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Entity Type | Individual
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Provider Name | PREMCHAND ANNE M.D., M.B.A., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 22201 MOROSS RD PB II, SUITE 275
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City | DETROIT
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State | MI
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Zip | 48236-2169
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Country | US
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Telephone | 313-343-4887
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Fax | 313-343-6822
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Provider Business Mailing Address
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Address Line | 22201 MOROSS RD STE 275
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City | DETROIT
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State | MI
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Zip | 48236-2176
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Country | US
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Telephone | 313-343-6840
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301080539
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 4301080539
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301080539
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License Number State | MI
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