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General NPI Number Information
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NPI Number | 1881005114
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Entity Type | Organization
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Legal Business Name | ALPHA MEDICAL SERVICES PC
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 26131, SUNBURY CT
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City | NOVI
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State | MI
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Zip | 48374
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Country | US
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Telephone | 248-895-2069
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Fax | 248-697-9720
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Provider Business Mailing Address
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Address Line | 25500 GODDARD RD
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City | TAYLOR
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State | MI
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Zip | 48180-3926
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Country | US
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Telephone | 313-914-2395
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Fax | 313-914-2437
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Authorized Official
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Title or Position | MD/OWNER
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Name | HARI KUMAR DANDAPANTULA
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Credential | MD
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Telephone | 248-895-2069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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