Individual
AMUDHA PALAIYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2799 W GRAND BLVD # K14, DETROIT, MI 48202-2608
(313) 916-2966
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4704258315
MI
363LG0600X
Gerontology Nurse Practitioner
Primary
4704258315
MI
Other
Enumeration date
05/04/2017
Last updated
10/15/2025
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