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Individual

DR. SRILATHA MALLU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2799 W GRAND BLVD, HENRY FORD HOSPITAL, DETROIT, MI 48202-2608
(313) 916-4872
Mailing address
28849 HEARTHSTONE DR, NOVI, MI 48377-2722
(248) 438-1038

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35-096328
OH
207L00000X
Anesthesiology Physician
4301079527
MI
207L00000X
Anesthesiology Physician
Primary
ME133784
FL

Other

Enumeration date
05/22/2007
Last updated
03/26/2026
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