Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | SD040021 | MI |
NPI | 1174503221 |
---|---|
Provider Name | Dr. Seshagiri Dandamudi |
First Address | Battle Creek, MI 49037-2331 |
Second Address | Battle Creek, MI 49037-3461 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 10/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101391024 | (05) | MI |
A73805 | (02) | MI |