Individual
DR. RADHIKA K THALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
27901 WOODWARD AVE, SUITE #210, BERKLEY, MI 48072-0919
(248) 414-5377
Mailing address
47652 ADRIANA CT, CANTON, MI 48187-1336
(734) 237-1923
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301089117
MI
207RN0300X
Nephrology Physician
Primary
4301089117
MI
Other
Enumeration date
01/23/2007
Last updated
09/08/2009
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