Individual
DR. MANJULI KODAGODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4803
(248) 849-3000
Mailing address
16001 W 9 MILE ROAD, SOUTHFIELD, MI 48075-4803
(248) 849-3000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301097423
MI
Other
Enumeration date
06/06/2011
Last updated
06/06/2011
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