Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301096269 | MI |
N | 111NI0900X | Internist | 4301096269 | MI |
Y | 207RH0003X | Hematology & Oncology | 4301096269 | MI |
NPI | 1053630749 |
---|---|
Provider Name | Hemasri Tokala |
First Address | Kalamazoo, MI 49007-3731 |
Second Address | Kalamazoo, MI 49007-3731 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2010 |
Last Update Date | 30/09/2020 |