Provider Demographics
NPI:1528089497
Name:DUVOOR, ANU (MD)
Entity type:Individual
Prefix:DR
First Name:ANU
Middle Name:
Last Name:DUVOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANUPAMA
Other - Middle Name:
Other - Last Name:VARADARAJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15520 19 MILE ROAD
Mailing Address - Street 2:SUITE 480
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6332
Mailing Address - Country:US
Mailing Address - Phone:586-228-1010
Mailing Address - Fax:586-228-8570
Practice Address - Street 1:15520 19 MILE ROAD
Practice Address - Street 2:SUITE 480
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-6332
Practice Address - Country:US
Practice Address - Phone:586-228-1010
Practice Address - Fax:586-228-8570
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063991207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E07884Medicare PIN