Individual
DR. SUPRIYA RAINA-HUKKU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2964
Mailing address
46239 BROOKSIDE NORTH DR, MACOMB, MI 48044-5451
(847) 932-9169
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
036128898
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301088570
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD185514
OR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD60801236
WA
Other
Enumeration date
06/01/2007
Last updated
05/06/2020
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