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NPI Code Detail

MEDICARE: SUDHEER B MALGIREDDY

MEDICARE: SUDHEER B MALGIREDDY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302035265MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1M426778081638OTHERMIDRIVERS LISCENCE

General Provider Information

NPI Number : 1093937096
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUDHEER B MALGIREDDY
Provider Business Mailing Address
First Line : 35705 N GRANDVIEW CT
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48335
Country : US
Telephone Number : 248-699-7822
Fax Number :
Provider Business Practice Location Address
First Line : 2003 E 12 MILE RD
Second Line :
City : WARREN
State : MI
Zip : 48092-5642
Country : US
Telephone Number : 586-751-3600
Fax Number : 586-751-1257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 07/08/2007

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Directions to “ SUDHEER B MALGIREDDY ” Practice Location

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