Individual
LALITHA K SASTRY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15855 WEST 19 MILE RD, ST JOSEPHS MEDICAL CENTER, CLINTON TWP, MI 48038
(586) 263-2300
(586) 263-2595
Mailing address
PO BOX 55 114, DETROIT, MI 48255
(248) 858-3197
(248) 858-3148
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036197
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0821554
BCBS TRUST
MI
05
—
4843897
—
MI
Enumeration date
05/23/2006
Last updated
07/08/2007
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