Individual
NANJAPPA C SADASIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2333 BIDDLE AVENUE, WYANDOTTE, MI 48192
(734) 677-7400
(734) 677-7407
Mailing address
PO BOX 1108, ATTN: BARB SIMMONS, ANN ARBOR, MI 48106-1108
(734) 677-7400
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301033633
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0996742
HEALTHPLUS
MI
01
—
11293247
CAQH
MI
01
—
119545
SELECTCARE
MI
05
—
1680573
—
MI
01
—
3009503251
BCBS OF MI
MI
01
—
321192
ULTIMED ID NBR
MI
01
—
B45247
HEALTH ALLIANCE PLAN NBR
MI
01
—
P00060426
RR MEDICARE PIN
MI
Enumeration date
04/19/2006
Last updated
07/14/2009
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