Individual provider · Type 1 NPI

Kiran Sooraj Thirukonda Jegadeesh Babu, MD

Student in an Organized Health Care Education/Training Program · Clinton Township, MI

NPI number 1457295776 Active

Practice location

Henry Ford Macomb Hospital, 15855 19 Mile Rd.,
Clinton Township, MI 48038

Call (313) 916-1601 Map

Fax (313) 916-2018

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1457295776

Kiran Sooraj Thirukonda Jegadeesh Babu, MD's National Provider Identifier is 1457295776, issued on Apr 16, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Clinton Township, MI. The record was last updated on Oct 19, 2026.