Individual provider · NPI-1

Pradeep Balasubramanian, M.D.

Dermatology · Dearborn, MI

NPI number1376233403
StatusActive
Last updated in NPPESOct 20, 2025

Details

NPI
1376233403
Entity type
Individual (NPI-1)
Name
Mr. Pradeep Balasubramanian
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
May 11, 2023
Certification date
Oct 20, 2025
Last updated
Oct 20, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X Dermatology4301512568MIYes

Practice location

5250 Auto Club Dr Ste 290a
Dearborn, MI 48126-2619

Phone 313-448-9220 · Fax 313-221-9957

Mailing address

400 Mack Ave
Detroit, MI 48201-2136

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