Provider Demographics
NPI:1386750396
Name:ADULT & CHILD HEALTH CARE P.C.
Entity type:Organization
Organization Name:ADULT & CHILD HEALTH CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SURYAKUMARI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTHIKONDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-466-9000
Mailing Address - Street 1:30260 CHERRY HILL RD
Mailing Address - Street 2:STE A
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2615
Mailing Address - Country:US
Mailing Address - Phone:734-466-9000
Mailing Address - Fax:734-466-9700
Practice Address - Street 1:30260 CHERRY HILL RD
Practice Address - Street 2:STE A
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2615
Practice Address - Country:US
Practice Address - Phone:734-466-9000
Practice Address - Fax:734-466-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43630207R00000X
2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1679527758OtherNPI # FOR RAO N GUTHIKON
MI1043264120OtherNPI # FOR SURYAKUMARI GU