Individual
MS. SUMATHI PARVATANENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1711 S STEPHENSON AVE, SUITE 210, IRON MOUNTAIN, MI 49801-3639
(906) 776-5800
Mailing address
1711 S STEPHENSON AVE, SUITE 210, IRON MOUNTAIN, MI 49801-3639
(906) 776-5800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301084683
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34670400
—
WI
05
—
4866318
—
MI
01
—
941311044861
PREFERRED ONE
MI
01
—
SA084683
BLUE CROSS MI
MI
Enumeration date
12/11/2006
Last updated
07/09/2007
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