Individual
SHILPA KODATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 WALL ST, ANN ARBOR, MI 48105-1912
(734) 764-4190
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
252783
MA
207W00000X
Ophthalmology Physician
Primary
4301507901
MI
207W00000X
Ophthalmology Physician
RS2015-0468
NM
Other
Enumeration date
07/09/2012
Last updated
10/21/2022
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