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NPI Code Detail

MEDICARE: SANGITA PRADHAN MD

MEDICARE: SANGITA PRADHAN 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
1207Q00000XFamily Medicine PhysicianSP074932MI
2207R00000XInternal Medicine Physician4301074932MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11108225022OTHERMIBCBS NUMBERS

General Provider Information

NPI Number : 1144290446
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANGITA PRADHAN MD
Provider Business Mailing Address
First Line : 441 S LIVERNOIS RD STE 185
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-2585
Country : US
Telephone Number : 248-651-1155
Fax Number : 248-651-8537
Provider Business Practice Location Address
First Line : 441 S LIVERNOIS RD STE 185
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-2585
Country : US
Telephone Number : 248-651-1155
Fax Number : 248-651-8537
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 09/15/2021

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Directions to “ SANGITA PRADHAN MD” Practice Location

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