Individual
MR. HARGOPAL TEKUMULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501008202
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G41113
BLUE CARE NETWORK, MICHIGAN
MI
01
—
164232
GREAT LAKES HEALTH PLAN
MI
01
—
48102
HEALTH PLAN OF MICHIGAN
MI
05
—
4863011
—
MI
01
—
650G411130
BCBS OF MICHIGAN
MI
Enumeration date
10/25/2006
Last updated
11/04/2008
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