MR. ANIRUDH KOTHA (NPI# 1467078857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467078857 |
| Entity Type | Individual |
| Full Name | MR. ANIRUDH KOTHA |
| Credential | M.D. |
| Practice Address |
22151 Moross Rd Ste 214 Detroit MI 48236 |
| Practice Telephone | 3133434867 |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2020-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
22151 MOROSS RD STE 214 |
| City | DETROIT |
| State | MI |
| Zip Code | 48236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366440463 | Christine Ann Crader | Internal Medicine | 22151 Moross Rd, Detroit, MI 48236-2167 | 2005-07-12 |
| 1386147981 | Carla Freigeh | Physician Assistant | 22151 Moross Rd, Detroit, MI 48236-2167 | 2018-03-10 |
| 1245738822 | Stacey Alise Joiner | Counselor | 22151 Moross Rd, Detroit, MI 48236-2167 | 2018-01-29 |
| 1730618158 | Victoria Elizabeth Simmons | Surgery | 22151 Moross Rd, Suite 214, Detroit, MI 48236 | 2017-06-08 |
| 1902356272 | Jisha Dudeesh | Nurse Practitioner | 22151 Moross Rd, Professional Building One, Detroit, MI 48236-2167 | 2016-10-10 |
| 1841740792 | Celia Shallal | Social Worker | 22151 Moross Rd, Pb1, Detroit, MI 48236-2167 | 2016-10-04 |
| 1841668308 | Moayad Tarboush | Student in an Organized Health Care Education/Training Program | 22151 Moross Rd, Detroit, MI 48236-2167 | 2015-09-14 |
| 1285023226 | Lauren Krist | Nurse Practitioner | 22151 Moross Rd, Detroit, MI 48236-2167 | 2015-01-14 |
| 1194122937 | Patricia Vassallo | Nurse Practitioner | 22151 Moross Rd, Pb 2 Suite 209, Detroit, MI 48236-2167 | 2014-11-21 |
| 1861736431 | Amer Abdul-hafiz Afaneh | Surgery | 22151 Moross Rd, Suite 212, Detroit, MI 48236-2167 | 2012-11-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912516790 | Omar Choudhury | Student in an Organized Health Care Education/Training Program | Henroy Ford Hospital, Medical Education Department ., 2799 W. Grand Boulevard, Detroit, MI 48202-2608 | 2020-07-28 |
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1932725959 | Devonn Eli Israil | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St Rm 2d, Detroit, MI 48201-2153 | 2020-06-25 |
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.