Ezhuthachan, Sudhakar G.

Ezhuthachan, Sudhakar G. is an individual health care provider with primary practice located at Henry Ford Health System 2799 West Grand Boulevard, Detroit MI 48202. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Ezhuthachan, Sudhakar G. can be contacted via phone (313) 916-2436.

Contact Information

Primary practice address
Henry Ford Health System 2799 West Grand Boulevard Detroit MI 48202
Phone: (313) 916-2436
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301045923 Michigan
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 4301045923 Michigan

Profile Details

NPI number 1972675676
LBN Legal business name Ezhuthachan, Sudhakar G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2006
Last updated Jul 16th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972675676 NPPES
Michigan MEDICAID 143010410
Michigan Other SE045923
Michigan Other SE045923
Michigan Other 700H262280

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