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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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