Provider Demographics
NPI:1851096143
Name:LUVSANNYAM, ENKHMAA (MD)
Entity Type:Individual
Prefix:
First Name:ENKHMAA
Middle Name:
Last Name:LUVSANNYAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22250 PROVIDENCE DRIVE 7PMB
Mailing Address - Street 2:SUITE #703A
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4818
Mailing Address - Country:US
Mailing Address - Phone:248-849-5862
Mailing Address - Fax:248-849-8117
Practice Address - Street 1:22250 PROVIDENCE DRIVE
Practice Address - Street 2:7PMB SUITE #703A
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-849-5862
Practice Address - Fax:248-849-8117
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program