Individual
GIRISH GANDIKOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 2ND FLOOR TAUBMAN CENTER RECP A, ANN ARBOR, MI 48109-5326
(734) 936-4500
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301084734
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4702324
—
MI
Enumeration date
10/16/2006
Last updated
12/13/2018
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