Individual
DR. SRINIVASA RAO KODALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17940 FARMINGTON ROAD, SUITE 230, LIVONIA, MI 48152-3194
(734) 422-4748
(734) 422-5076
Mailing address
17940 FARMINGTON ROAD, SUITE 230, LIVONIA, MI 48152-3194
(734) 422-4748
(734) 422-5076
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301049890
MI
2084P0802X
Addiction Psychiatry Physician
4301049890
MI
2084P0805X
Geriatric Psychiatry Physician
4301049890
MI
Other
Enumeration date
06/10/2006
Last updated
11/04/2015
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