Organization
PRIME CARE PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GIRIJA MARIPUDI MD (OWNER)
(248) 583-0960
Entity
Organization
Contact information
Practice address
121 W 13 MILE RD, MADISON HEIGHTS, MI 48071-1857
(248) 583-0960
(248) 583-0961
Mailing address
121 W 13 MILE RD, MADISON HEIGHTS, MI 48071-1857
(248) 583-0960
(248) 583-0961
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301066341
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4593972
—
MI
Enumeration date
04/03/2008
Last updated
02/25/2013
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