Individual
NISHANT KRISHAN PURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 E MEDICAL CENTER DR, 1ST FLOOR TAUBMAN CENTER RECP G, ANN ARBOR, MI 48109-5334
(800) 333-9013
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35124111
OH
207R00000X
Internal Medicine Physician
4301111789
MI
207RN0300X
Nephrology Physician
Primary
4301111789
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OH
Enumeration date
06/20/2011
Last updated
04/10/2018
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