Individual
SAI SAMYUKTHA BANDARU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3541
(248) 849-2899
Mailing address
22301 FOSTER WINTER DRIVE PROVIDENCE CANCER CENTER,, SOUTHFIELD, MI 48075-3707
(248) 849-3541
(248) 849-2899
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4351050876
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2020
Last updated
02/07/2025
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