Organization
MICHIGAN PAIN&SPINE CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRUTHI KONDUR MD (PRESIDENT)
(313) 495-7200
Entity
Organization
Contact information
Practice address
4201 SAINT ANTOINE ST, SUITE 6B, UNIVERSITY HEALTH CENTER, DETROIT, MI 48201-2153
(313) 495-7200
(313) 495-7104
Mailing address
4201 SAINT ANTOINE ST, SUITE 6B, UNIVERSITY HEALTH CENTER, DETROIT, MI 48201-2153
(313) 495-7200
(313) 495-7104
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
4301086330
MI
Other
Enumeration date
12/21/2015
Last updated
12/21/2015
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