Provider Demographics
NPI:1790132439
Name:KANERVIKKOAHO-CRANE, SAARA (MD)
Entity Type:Individual
Prefix:
First Name:SAARA
Middle Name:
Last Name:KANERVIKKOAHO-CRANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAARA
Other - Middle Name:
Other - Last Name:CRANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1517 GRANGER AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1517 GRANGER AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4426
Practice Address - Country:US
Practice Address - Phone:734-213-2012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040619207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology