Individual
DR. VASAN H DESHIKACHAR
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
11803 GRAND RIVER AVE, DETROIT, MI 48204-1810
(313) 491-5544
(313) 491-7433
Mailing address
11803 GRAND RIVER AVE, DETROIT, MI 48204-1810
(313) 491-5544
(313) 491-7433
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301062217
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108257051
BCBS
MI
05
—
4596179
—
MI
Enumeration date
06/09/2006
Last updated
07/08/2007
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