Individual
MOHAN C MADALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2134 HAMPTON PL, OKEMOS, MI 48864-3691
(517) 347-3000
(517) 347-8393
Mailing address
2134 HAMPTON PL, OKEMOS, MI 48864-3691
(517) 347-3000
(517) 347-8393
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301077662
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295949030
—
MI
Enumeration date
05/10/2007
Last updated
06/13/2011
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