Healthcare Provider Details

I. General information

NPI: 1467641951
Provider Name (Legal Business Name): USHA R TAMPI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 03/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 N MACOMB ST SUITE 229
MONROE MI
48162-2900
US

IV. Provider business mailing address

730 N MACOMB ST SUITE 229
MONROE MI
48162-2900
US

V. Phone/Fax

Practice location:
  • Phone: 734-243-4220
  • Fax: 734-457-3131
Mailing address:
  • Phone: 734-243-4220
  • Fax: 734-457-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number039683
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: