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NPI Code Detail

MEDICARE: DR. USHA PASUPULETI MD

MEDICARE: DR. USHA PASUPULETI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QG0300XGeriatric Medicine (Family Medicine) Physician125081155IL
2390200000XStudent in an Organized Health Care Education/Training Program
3207R00000XInternal Medicine Physician11020928AIN

General Provider Information

NPI Number : 1396371316
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. USHA PASUPULETI MD
Provider Business Mailing Address
First Line : 5000 S 5TH AVE
Second Line :
City : HINES
State : IL
Zip : 60141-3030
Country : US
Telephone Number : 708-202-8387
Fax Number :
Provider Business Practice Location Address
First Line : 13210 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48215-2704
Country : US
Telephone Number : 313-335-3444
Fax Number : 313-484-4998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2020
Last Update Date : 04/08/2026

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