| Pradeep G Prabhu, MD | |
| 
					Henry Ford Health System, 24565 Haig Road, Taylor, MI 48180  | |
| (313) 375-2000 | |
| (313) 375-2165 | 
| Full Name | Pradeep G Prabhu | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics | 
| Location | Henry Ford Health System, Taylor, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1487701298 | NPI | - | NPPES | 
| PP062997 | Other | COMMERCIAL-COMMERCIAL NUMBER | |
| 324562410 | Medicaid | MI | |
| 700H262280 | Other | BLUE CROSS-BLUE CROSS | |
| PP062997 | Other | CHAMPUS-CHAMPUS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 4301062997 (Michigan) | Primary | 
| Entity Name | Henry Ford Health System | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Pradeep G Prabhu, MD Henry Ford Health System, 24565 Haig Road, Taylor, MI 48180 Ph: (313) 375-2000  | Pradeep G Prabhu, MD Henry Ford Health System, 24565 Haig Road, Taylor, MI 48180 Ph: (313) 375-2000  | 
Marium Mohammed Iqbal, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 24555 Haig St, Taylor, MI 48180 Phone: 313-375-2161 Fax: 313-375-2165  | |
Sudha Rudraraju, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Henry Ford Health System, 24565 Haig Road, Taylor, MI 48180 Phone: 313-375-2000 Fax: 313-375-2235  | |
Sultana Rokeya Ghuznavi, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 25412 Goddard Rd, Taylor, MI 48180 Phone: 313-292-4110 Fax: 313-292-9512  | |
Harjit Kaur Kohli, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 26650 Eureka Rd, Suite C-1, Taylor, MI 48180 Phone: 734-941-4991 Fax: 734-941-4919  | |
Stephanie Kate Langer, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 10000 Telegraph Rd, Taylor, MI 48180 Phone: 949-677-4638  | |
Mhd-hussam Diarbakrli, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 23611 Goddard Rd, Suite B, Taylor, MI 48180 Phone: 734-250-7887 Fax: 734-250-8091  |