Provider Demographics
NPI:1780790071
Name:SARAN, NIHAL (MD)
Entity type:Individual
Prefix:
First Name:NIHAL
Middle Name:
Last Name:SARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19445 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3361
Mailing Address - Country:US
Mailing Address - Phone:313-307-0088
Mailing Address - Fax:313-281-2235
Practice Address - Street 1:1061 INKSTER RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-3168
Practice Address - Country:US
Practice Address - Phone:734-291-0005
Practice Address - Fax:313-281-2235
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2021-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010441832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4626527 TYPE 10Medicaid
MIA 74065Medicare UPIN
MIP54680001Medicare PIN
MI0N84140Medicare ID - Type Unspecified