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Organization
SUDHA NANNAPANENI MD PLLC
Active
Organization
SUDHA NANNAPANENI MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHA NANNAPANENI MD (OWNER)
(313) 300-4083
Entity
Organization
Contact information
Practice address
18285 E 10 MILE RD STE 120, ROSEVILLE, MI 48066-5806
(586) 771-4830
Mailing address
18285 E 10 MILE RD STE 120, ROSEVILLE, MI 48066-5806
(586) 771-4830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301070308
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104290526
—
MI
Enumeration date
09/16/2009
Last updated
10/07/2011
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