Individual
DURGA MULPURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15050 E JEFFERSON AVE, GROSSE POINTE PARK, MI 48230-2050
(313) 823-4682
(313) 823-8022
Mailing address
15050 E JEFFERSON AVE, GROSSE POINTE PARK, MI 48230-2050
(313) 823-4682
(313) 823-8022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301068839
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4456884
—
MI
01
—
700H249730
BCBS GROUP NUMBER
MI
Enumeration date
11/03/2005
Last updated
06/23/2009
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