Individual
MALITHA SAMANTHIKA HETTIARACHCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
26677 W 12 MILE RD # B6, SOUTHFIELD, MI 48034-1514
(248) 354-4709
(248) 354-4807
Mailing address
PO BOX 674147, DETROIT, MI 48267-4147
(248) 354-4709
(248) 354-4807
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301092203
MI
Other
Enumeration date
12/01/2011
Last updated
12/20/2024
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