Basic Information
Provider Information
NPI: 1225048341
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KULKARNI
FirstName: ARUN
MiddleName: G
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6427 ROYAL POINTE DRIVE
Address2:  
City: WEST BLOOMFIELD
State: MI
PostalCode: 48322
CountryCode: US
TelephoneNumber: 7347210200
FaxNumber: 7347212008
Practice Location
Address1: 33101 ANNAPOLIS
Address2: SUITE B PSYCHIATRIC INTERVENTION CENTER
City: WAYNE
State: MI
PostalCode: 48184
CountryCode: US
TelephoneNumber: 7347210200
FaxNumber: 7347212008
Other Information
ProviderEnumerationDate: 08/09/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X4301050798MIY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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