Provider Demographics
NPI:1922098235
Name:ERBEN, ANNE M (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:ERBEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2950 E WATTLES RD STE 300
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-7008
Mailing Address - Country:US
Mailing Address - Phone:248-524-2121
Mailing Address - Fax:248-524-2035
Practice Address - Street 1:2950 E WATTLES RD STE 300
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-7008
Practice Address - Country:US
Practice Address - Phone:248-524-2121
Practice Address - Fax:248-524-2035
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301055950207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI32503535Medicaid
MI32503535Medicaid
MI0M24170002Medicare PIN