Individual
MAYURA KULKARNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
7210 N MAIN ST STE 205, CLARKSTON, MI 48346-1575
(248) 625-9755
Mailing address
4715 BROOMFIELD WAY, LAKE ORION, MI 48359-1956
(806) 500-6312
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4704377143
MI
363LP0200X
Pediatric Nurse Practitioner
21237030501
MI
Other
Enumeration date
09/07/2021
Last updated
06/30/2022
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