Individual
DR. LAKSHMI HANASOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15555 NORTHLINE RD, SOUTHGATE, MI 48195-1896
(734) 285-3090
(734) 285-3095
Mailing address
15555 NORTHLINE RD, SOUTHGATE, MI 48195-1896
(734) 285-3090
(734) 285-3095
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4310172903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000943
CAPE HEALTH PLAN
MI
01
—
023843
MIDWEST HEALTH PLAN
MI
01
—
16298
MCARE
MI
05
—
4492610
—
MI
01
—
B43221
HA
MI
01
—
LH072903
BLUE CROSS MI LICENSE
MI
Enumeration date
10/21/2006
Last updated
07/21/2022
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