MEDICARE: LEELA PALADUGU MD, PHD

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
1	2084P0800X	Psychiatry Physician	4351050387	MI

General Provider Information

NPI Number	:	1477276012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEELA PALADUGU MD, PHD

Provider Business Mailing Address
First Line	:	4201 SAINT ANTOINE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2153
Country	:	US
Telephone Number	:	989-397-4413
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 SAINT ANTOINE ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2153
Country	:	US
Telephone Number	:	313-745-5146
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2022
Last Update Date	:	02/10/2026

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