Provider Demographics
NPI:1932252145
Name:BALCHANDANI, KIRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRAN
Middle Name:
Last Name:BALCHANDANI
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 1:1181 N MILFORD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1016
Mailing Address - Country:US
Mailing Address - Phone:248-685-0444
Mailing Address - Fax:248-684-0900
Practice Address - Street 1:1181 N MILFORD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1016
Practice Address - Country:US
Practice Address - Phone:248-685-0444
Practice Address - Fax:248-684-0900
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046746207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4514950Medicaid
MIA78881Medicare UPIN
MI4514950Medicaid