Individual
MANJUNATH BAGEWADI ELLUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13111 WOODWARD AVE, HIGHLAND PARK, MI 48203-3781
(313) 865-9900
Mailing address
13111 WOODWARD AVE, HIGHLAND PARK, MI 48203-3781
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302037567
MI
Other
Enumeration date
04/20/2018
Last updated
04/20/2018
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