Individual
LAXMI P. PRABHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 6100 HAGGERTY ROAD, CANTON, MI 48187
(734) 981-3200
(734) 981-4354
Mailing address
HENRY FORD HEALTH SYSTEM, 6100 HAGGERTY ROAD, CANTON, MI 48187
(734) 981-3200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301062996
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP062996
CHAMPUS-CHAMPUS
—
Enumeration date
01/04/2007
Last updated
07/08/2007
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