Organization
SRINIVAS B. MUKKAMALA. M.D., P.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRINIVAS B MUKKAMALA M.D. (MEDICAL DOCTOR)
(810) 244-8400
Entity
Organization
Contact information
Practice address
1170 CHARTER DR, SUITE F, FLINT, MI 48532
(810) 244-8400
Mailing address
1170 CHARTER DR, SUITE F, FLINT, MI 48532-3587
(810) 244-8400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301075543
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4203511
—
MI
Enumeration date
11/16/2006
Last updated
08/28/2018
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