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NPI Code Detail

MEDICARE: SRIKALA YEDAVALLY-YELLAYI DO

MEDICARE:   SRIKALA  YEDAVALLY-YELLAYI  DO
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
1207Q00000XFamily Medicine Physician5101010648MI

General Provider Information

NPI Number : 1316927239
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRIKALA YEDAVALLY-YELLAYI DO
Provider Business Mailing Address
First Line : 44250 DEQUINDRE ROAD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48314-1002
Country : US
Telephone Number : 248-964-0400
Fax Number : 248-964-0401
Provider Business Practice Location Address
First Line : 44250 DEQUINDRE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48314-1002
Country : US
Telephone Number : 248-964-0400
Fax Number : 248-964-0401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 10/22/2020

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Directions to “ SRIKALA YEDAVALLY-YELLAYI DO” Practice Location

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