Organization
MARUTI MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASAD POLICHERLA M.D. (PRESIDENT)
(248) 424-8623
Entity
Organization
Contact information
Practice address
20500 ANITA ST, HARPER WOODS, MI 48225-1115
(248) 424-8623
Mailing address
20500 ANITA ST, HARPER WOODS, MI 48225-1115
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
4301061567
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L2123473
—
MI
Enumeration date
11/18/2009
Last updated
11/18/2009
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