# MARUTI MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003144700
- **Authorized official:** DR. PRASAD POLICHERLA M.D. (PRESIDENT)
- **Authorized official phone:** (248) 424-8623

## Contact information

- **Practice address:** 20500 ANITA ST, HARPER WOODS, MI 48225-1115
- **Practice address phone:** (248) 424-8623
- **Mailing address:** 20500 ANITA ST, HARPER WOODS, MI 48225-1115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4301061567 | MI | Yes |

## Other

- **Enumeration date:** 11/18/2009
- **Last updated:** 11/18/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | L2123473 | — | MI |