Provider Demographics
NPI:1255436309
Name:KOGULAN, PALANIANDY K (MD)
Entity type:Individual
Prefix:DR
First Name:PALANIANDY
Middle Name:K
Last Name:KOGULAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:801 JOE MANN BLVD STE P6
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-8900
Mailing Address - Country:US
Mailing Address - Phone:989-791-2455
Mailing Address - Fax:989-791-1392
Practice Address - Street 1:2233 N CENTER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3730
Practice Address - Country:US
Practice Address - Phone:989-791-7085
Practice Address - Fax:989-791-7068
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2024-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301082867207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1699090415OtherPPOM
MI1699090415OtherAETNA
MI1699090415Medicaid
MIH27977Medicare UPIN