Healthcare Provider Details

I. General information

NPI: 1295092849
Provider Name (Legal Business Name): SRI BHARATHI YADLAPALLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 12/26/2024
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44405 WOODWARD AVENUE SUITE 202
PONTIAC MI
48341-5023
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DRIVE SUITE J2000
ANN ARBOR MI
48105
US

V. Phone/Fax

Practice location:
  • Phone: 248-858-2270
  • Fax: 248-335-6171
Mailing address:
  • Phone: 734-747-6766
  • Fax: 734-222-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301100485
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number4301100485
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number4301100485
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: