Individual
BALAMATHEW R PUDOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
502 S BALLENGER HWY, FLINT, MI 48532-3640
(810) 424-9270
Mailing address
2160 E HILL RD, APT #41, GRAND BLANC, MI 48439-5183
(810) 919-8567
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302039319
MI
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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