Provider Demographics
NPI:1104677160
Name:FOUTY, ANNA (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:FOUTY
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 1:1500 E MEDICAL CENTER DR. SPC 5368
Mailing Address - Street 2:3116 N TAUBMAN CENT
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-2335
Mailing Address - Country:US
Mailing Address - Phone:734-998-2020
Mailing Address - Fax:
Practice Address - Street 1:375 BRIARWOOD CIR BLDG 3
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1605
Practice Address - Country:US
Practice Address - Phone:734-998-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351053952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine