1326049537 NPI number — ANAND N HIREMATH MD

Table of content: ANAND N HIREMATH MD (NPI 1326049537)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326049537 NPI number — ANAND N HIREMATH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HIREMATH
Provider First Name:
ANAND
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326049537
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16407 SOUTHFIELD RD STE 207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLEN PARK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48101-2571
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-271-3000
Provider Business Mailing Address Fax Number:
313-271-3003

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16407 SOUTHFIELD RD STE 207
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLEN PARK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48101-2571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-271-3000
Provider Business Practice Location Address Fax Number:
313-271-3003
Provider Enumeration Date:
08/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  4301064516 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110Q26434 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 2652 . This is a "CAPE HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 110086587 C30371 . This is a "TRAVELERS MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 101295 . This is a "GREAT LAKES HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 204980 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: P89830 G02484 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: C5235 . This is a "M-CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 107923 . This is a "CARE CHOICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4241512 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4481492 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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