Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 5101017275 | MI |
NPI | 1053536755 |
---|---|
Provider Name | Dr. Prashant Sudhir Kelkar |
First Address | Southfield, MI 48075-6214 |
Second Address | Southfield, MI 48075-6214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 18/01/2016 |