Individual
MINU MATHEW PUTHUPPALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2212 LAKESIDE DR, TROY, MI 48085-1043
(248) 635-2361
Mailing address
2212 LAKESIDE DR, TROY, MI 48085-1043
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704374146
MI
Other
Enumeration date
11/01/2025
Last updated
11/01/2025
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