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General NPI Number Information
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NPI Number | 1225479678
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Entity Type | Individual
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Provider Name | SRUTHI JINNA MD
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Gender | Female
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | TRINITY HEALTH IHA MEDICAL GROUP ENDOCRINOLOGY 19000 ST JOE'S PARKWAY STE 300
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City | LIVONIA
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State | MI
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Zip | 48152-1477
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Country | US
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Telephone | 734-884-5196
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Fax | 248-696-3175
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Provider Business Mailing Address
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Address Line | 24 FRANK LLOYD WRIGHT DRIVE SUITE J2000
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City | ANN ARBOR
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State | MI
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Zip | 48105
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Country | US
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Telephone | 734-884-5196
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Fax | 248-696-3175
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301102959
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301102959
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 4301102959
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License Number State | MI
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