MEDICARE: KIRAN KINRA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	KK042002	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4414745	OTHER		AETNA
3	010021744	OTHER		PALMETTO GBA
4	1102500432	OTHER	MI	BLUE CROSS

General Provider Information

NPI Number	:	1033115944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRAN KINRA MD

Provider Business Mailing Address
First Line	:	1375 FLUSHING RD
Second Line	:
City	:	FLUSHING
State	:	MI
Zip	:	48433-2262
Country	:	US
Telephone Number	:	810-659-2233
Fax Number	:	810-659-2246

Provider Business Practice Location Address
First Line	:	1375 FLUSHING RD
Second Line	:
City	:	FLUSHING
State	:	MI
Zip	:	48433
Country	:	US
Telephone Number	:	810-659-2233
Fax Number	:	810-659-2246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	06/22/2018

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Directions to “ KIRAN KINRA MD” Practice Location

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