Provider Demographics
NPI:1194734806
Name:BABU, ANUSUYA (MD)
Entity type:Individual
Prefix:DR
First Name:ANUSUYA
Middle Name:
Last Name:BABU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1540 LAKE LANSING RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-3900
Mailing Address - Fax:517-913-3901
Practice Address - Street 1:1540 LAKE LANSING RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3756
Practice Address - Country:US
Practice Address - Phone:517-913-3900
Practice Address - Fax:517-913-3901
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2010-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301073403207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00809179OtherRAILROAD MEDICARE
MI1103305541OtherBLUE CARE NETWORK
MI200000022162OtherPHP FAMILYCARE
MI1053971OtherMCLAREN HEALTH PLAN-MEDICAID
MI1103305541OtherBLUE CROSS BLUE SHIELD
MI4110420OtherAETNA
MI1053971OtherMCLAREN HEALTH ADVANTAGE
MI0M21440071OtherMEDICARE ADVANTAGE
MI1053971OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI200000022162OtherPHP
MI1053971OtherMCLAREN HEALTH PLAN-MEDICAID
MI1103305541OtherBLUE CROSS BLUE SHIELD