Provider Demographics
NPI:1972155612
Name:LAKSHMAN, HARINI GAYITHRI (MD)
Entity type:Individual
Prefix:
First Name:HARINI
Middle Name:GAYITHRI
Last Name:LAKSHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22250 PROVIDENCE DR.,
Mailing Address - Street 2:SUITE 705
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4818
Mailing Address - Country:US
Mailing Address - Phone:248-552-9858
Mailing Address - Fax:248-849-9510
Practice Address - Street 1:22250 PROVIDENCE DR.,
Practice Address - Street 2:SUITE 705
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-552-9858
Practice Address - Fax:248-849-9510
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351045115207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease