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Organization

SG PEDIATRIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SRILAKSHMI PINNAMARAJU M.D (AUTHORIZED OFFICAIL)
(248) 662-4091
Entity
Organization

Contact information

Practice address
26850 PROVIDENCE PKWY, SUITE 320, NOVI, MI 48374-1213
(248) 662-4091
Mailing address
26850 PROVIDENCE PKWY, SUITE 320, NOVI, MI 48374-1213
(248) 662-4091

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4534292
MI
05
4566240
MI
05
4721221
MI
05
4721230
MI
Enumeration date
11/06/2006
Last updated
12/30/2013
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