Individual
DEV S NANDAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3030 COMMERCE DR, FORT GRATIOT, MI 48059-3819
(810) 385-9559
(810) 385-9515
Mailing address
3030 COMMERCE DR, FORT GRATIOT, MI 48059-3819
(810) 385-9559
(810) 385-9515
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301063724
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205802436
—
MI
Enumeration date
02/27/2006
Last updated
11/02/2020
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