Individual
SHABANA KALLADI PUTHANPURAYIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
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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