Organization
EASTSIDE CARDIOVASCULAR MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VAMSHIDHAR GUDUGUNTLA MD (DIRECTOR)
(313) 461-8684
Entity
Organization
Contact information
Practice address
25195 KELLY RD STE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Mailing address
25195 KELLY RD STE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
4301094061
MI
Other
Enumeration date
05/16/2017
Last updated
05/16/2017
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