Individual
DR. SRINIVASAN DHATREECHARA N
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 W HIGH ST, DOWAGIAC, MI 49047-1943
(269) 783-3017
Mailing address
420 W HIGH ST, DOWAGIAC, MI 49047-1943
(269) 783-3017
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301073450
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25-30174
PHP/IBA
MI
05
—
4212136
—
MI
01
—
P106615
BCN
MI
01
—
SD073450
BCBS
MI
Enumeration date
09/22/2006
Last updated
07/08/2007
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