Individual
SUSHMA TATINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
910 E 26TH ST # 100-200, MINNEAPOLIS, MN 55404-4526
(612) 884-6300
Mailing address
2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-2001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01084146A
IN
207RH0003X
Hematology & Oncology Physician
4351042649
MI
207RH0003X
Hematology & Oncology Physician
Primary
69531
MN
390200000X
Student in an Organized Health Care Education/Training Program
11017611A
IN
Other
Enumeration date
06/14/2014
Last updated
10/27/2022
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