Basic Information
| Provider Information | |||||||||
| NPI: | 1891741443 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BHRANY | ||||||||
| FirstName: | ANJANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1110 ELDON BAKER DRIVE | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102322766 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2830 CORUNNA RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485033254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102356812 | ||||||||
| FaxNumber: | 8102347022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 10/24/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TB0200X | 4301040601 | MI | N | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | 2084P0800X | 4301040601 | MI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 4671282 10 | 05 | MI | MEDICAID | 4671317 10 | 05 | MI | MEDICAID | 4671380 10 | 05 | MI | MEDICAID | 4671326 10 | 05 | MI | MEDICAID |