Individual
KUMBLA P BHAKTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 N PERRY ST, PONTIAC, MI 48342-2217
(248) 338-5000
Mailing address
PO BOX 210309, AUBURN HILLS, MI 48321-0309
(248) 935-8900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301033477
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4471352-10
—
MI
Enumeration date
08/22/2006
Last updated
07/08/2007
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