Organization
THEETHAYE ITTIARA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEETHAYE L ITTIARA (MD)
(517) 263-5810
Entity
Organization
Contact information
Practice address
142 E MAUMEE STREET SUITE 3, ADRIAN, MI 49221-3619
(517) 263-5810
Mailing address
142 E MAUMEE STREET SUITE 3, ADRIAN, MI 49221-3619
(517) 263-5810
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301031889
MI
Other
Enumeration date
03/01/2012
Last updated
03/01/2012
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