Individual
MADHAVI GANGADASU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35584 GRANDRIVER AVE, FARMINGTONHILLS, MI 48335
(248) 474-1717
(248) 474-2590
Mailing address
45505 ANDES HILLS CT, NOVI, MI 48374-1907
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302034889
MI
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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