Provider Demographics
NPI:1063537785
Name:COMPREHENSIVE HEALTHCARE ASSOCIATES AND PREVENTION MEDICINE PC
Entity type:Organization
Organization Name:COMPREHENSIVE HEALTHCARE ASSOCIATES AND PREVENTION MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBUJAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-671-0428
Mailing Address - Street 1:15140 LEVAN RD STE 40
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5027
Mailing Address - Country:US
Mailing Address - Phone:734-469-4664
Mailing Address - Fax:734-744-4180
Practice Address - Street 1:15140 LEVAN RD STE 40
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5027
Practice Address - Country:US
Practice Address - Phone:734-469-4664
Practice Address - Fax:734-744-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N90400Medicare PIN