Individual
SHABANA KALLADI PUTHANPURAYIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
3535 W 13 MILE RD STE 707, ROYAL OAK, MI 48073-6770
(248) 551-0487
(248) 551-3696
Mailing address
130 TOWN CENTER DR STE 203, TROY, MI 48084-1744
(248) 585-8250
(248) 585-8270
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301097882
MI
2080P0205X
Pediatric Endocrinology Physician
Primary
4301097882
MI
Other
Enumeration date
08/23/2011
Last updated
10/21/2020
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