Provider Demographics
NPI:1447330642
Name:MICHIGAN UNITED PHYSICIANS PC
Entity type:Organization
Organization Name:MICHIGAN UNITED PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-650-0096
Mailing Address - Street 1:2450 WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1481
Mailing Address - Country:US
Mailing Address - Phone:248-650-0096
Mailing Address - Fax:248-650-9831
Practice Address - Street 1:2450 WALTON BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1481
Practice Address - Country:US
Practice Address - Phone:248-650-0096
Practice Address - Fax:248-650-9831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI340F375640OtherBCBSM
MI0M92120Medicare ID - Type Unspecified