Individual
MADHAVI KANNEGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11670 MARTIN, WARREN, MI 48093
(586) 754-3830
(586) 754-3840
Mailing address
11670 MARTIN, WARREN, MI 48093
(586) 754-3830
(586) 754-3840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MK058470
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MK058470
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3357489
—
MI
01
—
P49707
BCN
MI
Enumeration date
11/20/2006
Last updated
09/13/2024
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