Individual
LATHA SREE POLAVARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
145 MICHIGAN ST NE STE 3100, GRAND RAPIDS, MI 49503-2563
(616) 954-9800
(616) 954-2116
Mailing address
5800 FOREMOST DR SE STE 300, GRAND RAPIDS, MI 49546-7062
(616) 954-9800
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4301083922
MI
Other
Enumeration date
05/21/2007
Last updated
03/17/2020
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