Individual
LATHA THIRUCHELVAN KANNAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22972 LAHSER RD, SOUTHFIELD, MI 48034-4408
(248) 353-4777
(248) 353-4235
Mailing address
34687 PICKFORD DR, FARMINGTON HILLS, MI 48335-2073
(248) 980-6150
(248) 353-4235
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
4301070401
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4646584
—
MI
Enumeration date
05/27/2006
Last updated
07/08/2007
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