Provider Demographics
NPI:1386849115
Name:SUDHA N. PUROHIT M.D.P.C.
Entity Type:Organization
Organization Name:SUDHA N. PUROHIT M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:PUROHIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-852-4000
Mailing Address - Street 1:2820 CROOKS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3607
Mailing Address - Country:US
Mailing Address - Phone:248-852-4000
Mailing Address - Fax:248-852-4949
Practice Address - Street 1:2820 CROOKS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3607
Practice Address - Country:US
Practice Address - Phone:248-852-4000
Practice Address - Fax:248-852-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056710207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F56503Medicare UPIN