Provider Demographics
NPI:1154427698
Name:GULANI, VIKAS (MD, PHD)
Entity type:Individual
Prefix:
First Name:VIKAS
Middle Name:
Last Name:GULANI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-936-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0883212085R0202X
MI43010784382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000221403OtherUNISON
OH2590441Medicaid
OH742690OtherBUCKEYE
OH000000503603OtherANTHEM
OH0304914OtherBCMH
OH768772OtherAETNA
OH363592OtherWELLCARE
OHP00358794OtherRAILROAD MEDICARE
OHP00358794OtherRAILROAD MEDICARE
OH768772OtherAETNA
OH742690OtherBUCKEYE