Individual
ANKUSH SURESH BHANDARKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4160 WOODWARD AVE FL 2, DETROIT, MI 48201-2027
(313) 264-3781
Mailing address
4160 WOODWARD AVE FL 2, DETROIT, MI 48201-2027
(313) 264-3781
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B536067011648
DRIVING LICENSE
MI
Enumeration date
09/19/2018
Last updated
09/19/2018
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