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General NPI Number Information
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NPI Number | 1164973095
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Entity Type | Organization
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Legal Business Name | SANTHAKUMAR NEUROLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 10/15/2016
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Last Update Date | 10/15/2016
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Provider Practice Location Address
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Address Line | 1423 WALTON BLVD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-1775
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Country | US
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Telephone | 248-495-7417
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Fax |
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Provider Business Mailing Address
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Address Line | 1423 WALTON BLVD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-1775
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Country | US
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Telephone | 248-495-7417
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Fax |
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Authorized Official
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Title or Position | NEUROLOGIST
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Name | DR. SUNITHA SANTHAKUMAR
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Credential | M.D
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Telephone | 248-495-7417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4301078149
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License Number State | MI
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