Individual
KIRANMAYI SURAPANENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
116 W 8 MILE RD, HAZEL PARK, MI 48030-2433
(248) 541-7606
(248) 541-7197
Mailing address
116 W 8 MILE RD, HAZEL PARK, MI 48030-2433
(248) 541-7606
(248) 541-7197
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301080888
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4654002
—
MI
Enumeration date
06/16/2006
Last updated
03/05/2010
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