Individual
BAN BATU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
18100 OAKWOOD BLVD STE 100, DEARBORN, MI 48124-4085
(313) 253-2030
Mailing address
3047 SUMERLYN CT, AUBURN HILLS, MI 48326-1799
(586) 718-3030
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704212005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430F364420
BCBSM
MI
05
—
4654085
—
MI
Enumeration date
02/28/2006
Last updated
11/13/2024
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