Organization
BLUE WATER CHILDREN'S HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEV NANDAMUDI MD (MD)
(810) 385-9559
Entity
Organization
Contact information
Practice address
3030 COMMERCE DR, FORT GRATIOT, MI 48059-3819
(810) 385-9559
(810) 385-9515
Mailing address
3030 COMMERCE DR, FORT GRATIOT, MI 48059-3819
(810) 385-9559
(810) 385-9515
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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