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Individual
SANGANUR V. MAHADEVAN
Active
Individual
SANGANUR V. MAHADEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301033200
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-08067781
BCBSM
MI
05
—
2095952
—
MI
Enumeration date
05/23/2006
Last updated
07/08/2007
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