Individual
ANNU MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2480 ROSEWOOD DRIVE, MOUNT PLEASANT, MI 48858
(989) 775-3823
(989) 773-5061
Mailing address
2480 ROSEWOOD DRIVE, MT. PLEASANT, MI 48858
(989) 775-3823
(989) 773-5061
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301078619
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01004961
HEALTHPLUS COMMERCIAL
MI
01
—
0803710282
BCBSM
MI
01
—
1012489
MCLAREN HEALTH PLAN
MI
01
—
200000005813
PHP COMMERCIAL
MI
05
—
4647367-10
—
MI
05
—
4652367-10
—
MI
Enumeration date
05/25/2006
Last updated
06/13/2011
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