Individual
SHIVAJEE V NALLAMOTHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5701 BOW POINTE DR, SUITE 300, CLARKSTON, MI 48346-3198
(248) 620-2325
(248) 620-2326
Mailing address
5701 BOW POINTE DR, SUITE 300, CLARKSTON, MI 48346-3198
(248) 620-2325
(248) 620-2326
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101012532
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4471209
—
MI
Enumeration date
01/26/2006
Last updated
12/10/2015
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