Individual
CHAITANYA LINGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 15401 EAST JEFFERSON, GROSSE POINTE PARK, MI 48230
(313) 824-4800
(313) 824-7080
Mailing address
HENRY FORD HEALTH SYSTEM, 15401 EAST JEFFERSON, GROSSE POINTE PARK, MI 48230
(313) 824-4800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301082303
MI
208M00000X
Hospitalist Physician
4301082303
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
489780610
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
CL082303
CHAMPUS-CHAMPUS
—
Enumeration date
07/01/2006
Last updated
10/20/2023
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