Organization
GREATER GENESEE COUNTY ACO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMASANDRAPALYA KIRAN MD (CHAIRMAN)
(810) 720-4200
Entity
Organization
Contact information
Practice address
1397 S LINDEN RD, SUITE D, FLINT, MI 48532-4194
(810) 720-4200
(810) 720-2711
Mailing address
1020 CHARTER DR, SUITE D, FLINT, MI 48532-3584
(810) 720-4200
(810) 720-2711
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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