Individual
DR. SRIVILLIPUTTUR GOPALAN SANTHANA KRISHNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
330 E BELTLINE AVE NE, SUITE 100, GRAND RAPIDS, MI 49506-1267
(616) 752-6235
(616) 328-8177
Mailing address
330 E BELTLINE AVE NE, SUITE 100, GRAND RAPIDS, MI 49506-1267
(616) 752-6235
(616) 328-8177
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301093886
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902850316
—
MI
Enumeration date
05/20/2006
Last updated
01/17/2020
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