Basic Information
| Provider Information | |||||||||
| NPI: | 1124751763 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KERI | ||||||||
| FirstName: | VISHAKH | ||||||||
| MiddleName: | CHANDRASHEKHAR | ||||||||
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| Credential: | DM | ||||||||
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| Mailing Information | |||||||||
| Address1: | DETROIT MEDICAL CENTER, GME OFFICE | ||||||||
| Address2: | 4201 ST. ANTOINE, UHC-9C | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137455146 | ||||||||
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| Practice Location | |||||||||
| Address1: | DETROIT MEDICAL CENTER, GME OFFICE | ||||||||
| Address2: | 4201 ST. ANTOINE, UHC-9C | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137455146 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2022 | ||||||||
| LastUpdateDate: | 09/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 4351050329 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.