Organization
SOUMYA MADALA MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOUMYA MADALA (OWNER)
(517) 339-0322
Entity
Organization
Contact information
Practice address
3937 PATIENT CARE WAY STE 102, LANSING, MI 48911-4287
(517) 887-6763
Mailing address
3937 PATIENT CARE DRIVE, #102, LANSING, MI 48911
(517) 887-6763
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301085495
MI
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
4301085495
MI
Other
Enumeration date
01/06/2010
Last updated
02/18/2010
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