Individual
BHAVANA PABBATI LIYANAARACHCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
11885 E 12 MILE RD STE 300A, WARREN, MI 48093-3467
(586) 582-6630
Mailing address
44190 DEEP HOLLOW CIR, NORTHVILLE, MI 48168-8414
(303) 330-3630
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101028151
MI
208M00000X
Hospitalist Physician
5101028151
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2021
Last updated
02/24/2025
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