Healthcare Provider Details

I. General information

NPI: 1033600630
Provider Name (Legal Business Name): KAMALA DEVI AKKINENI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAMALA AKKINENI

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1542 E PIERSON RD
FLUSHING MI
48433-1817
US

IV. Provider business mailing address

6123 QUARTZ CT
GRAND BLANC MI
48439-7832
US

V. Phone/Fax

Practice location:
  • Phone: 810-659-8057
  • Fax: 810-659-4099
Mailing address:
  • Phone: 810-845-5917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302035292
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: