Provider Demographics
NPI:1457665002
Name:HAYAT, ANIK ANITA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANIK
Middle Name:ANITA
Last Name:HAYAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANIK
Other - Middle Name:ANITA
Other - Last Name:ABRISHAMKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10083 SCENIC RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-9349
Mailing Address - Country:US
Mailing Address - Phone:305-924-4228
Mailing Address - Fax:
Practice Address - Street 1:255 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2218
Practice Address - Country:US
Practice Address - Phone:517-787-7399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097283207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology