=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922066828
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TULIKA NARAIN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2006
-----------------------------------------------------
Last Update Date | 09/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60005 CAMPGROUND RD STE 100
-----------------------------------------------------
City | WASHINGTON TOWNSHIP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48094-3446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-232-5355
-----------------------------------------------------
Fax | 586-745-9271
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2310 KINGSCROSS DR
-----------------------------------------------------
City | SHELBY TOWNSHIP
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48316-1208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-241-4444
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 4301511597
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 213792
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------