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Organization
SURINDER MENDIRATTA PLLC
Active
Organization
SURINDER MENDIRATTA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURINDER MENDIRATTA MD (OWNER)
(248) 395-2888
Entity
Organization
Contact information
Practice address
20905 GREENFIELD RD, STE 502, SOUTHFIELD, MI 48075-5360
(248) 395-2888
Mailing address
PO BOX 44047, DETROIT, MI 48244-0047
(248) 395-2888
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
SM060904
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106341161
BLUECROSS LICENSE
MI
01
—
SM060904
LICENSE
MI
Enumeration date
05/23/2007
Last updated
04/20/2008
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