Organization
NADIMPALLI RAJU MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NADIMPALLI RAJU MD (OWNER)
(248) 788-2406
Entity
Organization
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4000
Mailing address
6529 BURTONWOOD DR, WEST BLOOMFIELD, MI 48322-3244
(248) 788-2406
(248) 788-2406
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00161435
MEDICARE RAILROAD
—
Enumeration date
07/26/2010
Last updated
07/26/2010
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