Individual
SANJAY DANDAMUDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 BRADFORD ST NE, GRAND RAPIDS, MI 49525-6427
(616) 885-5000
(616) 885-5020
Mailing address
100 MICHIGAN ST NE # MC-845, GRAND RAPIDS, MI 49503-2560
(616) 885-5000
(616) 885-5020
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54083
MN
207RC0000X
Cardiovascular Disease Physician
036132618
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036132618
IL
Other
Enumeration date
06/18/2010
Last updated
02/24/2021
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