Individual
DATLA RAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2811 E COURT ST, FLINT, MI 48506-4054
(810) 232-6081
(810) 232-6510
Mailing address
6442 CHARLES DR, WEST BLOOMFIELD, MI 48322-4402
(248) 737-5183
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301041432
MI
Other
Enumeration date
06/16/2006
Last updated
03/18/2013
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