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Organization

ELITE HEALTH ASSOCIATES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SURESH MAMIDALA MD (PRESIDENT)
(917) 319-9180
Entity
Organization

Contact information

Practice address
602 AVALON WAY, SHREWSBURY, MA 01545-7804
(917) 319-9180
Mailing address
602 AVALON WAY, SHREWSBURY, MA 01545-7804

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
240724
MA
207R00000X
Internal Medicine Physician
Primary
241829
MA

Other

Enumeration date
03/28/2014
Last updated
04/30/2014
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