Organization
LIFESMART MEDICAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMITHA PARVATANENI MD (OWNER)
(313) 768-5096
Entity
Organization
Contact information
Practice address
2176 FORT ST, LINCOLN PARK, MI 48146-2405
(313) 768-5096
(877) 409-3290
Mailing address
2176 FORT ST, LINCOLN PARK, MI 48146-2405
(313) 768-5096
(877) 409-3290
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2024
Last updated
08/12/2025
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