Individual
HARANATH POLICHERLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26635 WOODWARD AVE, STE. 101, HUNTINGTON WOODS, MI 48070-1372
(248) 548-6400
(248) 548-8885
Mailing address
20160 MACK AVENUE, ATTN: SRINIVAS.PULAPAKA, GROSSE POINTE WOODS, MI 48236-1108
(313) 882-0640
(313) 882-3106
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301050806
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1308266221
BCBS PIN #
MI
05
—
4377860
—
MI
Enumeration date
07/22/2006
Last updated
07/09/2007
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