# PHADEJ KEOPUNNA MD PC

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

## Provider details

- **NPI number:** 1023289659
- **Authorized official:** PHADEJ KEOPUNNA MD (OWNER)
- **Authorized official phone:** (989) 792-6776

## Contact information

- **Practice address:** 70 N FROST DR, SAGINAW, MI 48638-5796
- **Practice address phone:** (989) 792-6776
- **Mailing address:** 70 N FROST DR, SAGINAW, MI 48638-5796
- **Mailing address phone:** (989) 792-6776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 0025266 | MI | Yes |

## Other

- **Enumeration date:** 03/24/2008
- **Last updated:** 03/24/2008