Individual
VENKATESWARA RAO MALINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 NORTH AVE, ST JOSEPH SPECIALTY HOSPITAL 215, MT CLEMENS, MI 48045
(586) 466-9889
(586) 466-9972
Mailing address
5341 PROVINCIAL DR, BLOOMFIELD HILLS, MI 48302
(888) 495-3999
(586) 466-9972
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
283787-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2606320151
BC
MI
05
—
296306310
—
MI
Enumeration date
07/12/2006
Last updated
03/29/2018
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