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Individual

DR. KAUSHIK ANNAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 WALL ST, ANN ARBOR, MI 48105-1912
(734) 764-4190
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LP04749
RI
207W00000X
Ophthalmology Physician
Primary
4301509010
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2524399
LA
Enumeration date
06/28/2019
Last updated
07/11/2023
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