MEDICARE: MRS. NAGAMANI PALAKA

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	183700000X	Pharmacy Technician	5303040237	MI

General Provider Information

NPI Number	:	1578294872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NAGAMANI PALAKA

Provider Business Mailing Address
First Line	:	23755 PHEASANT RUN
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48375-3349
Country	:	US
Telephone Number	:	843-801-5929
Fax Number	:

Provider Business Practice Location Address
First Line	:	42481 W 13 MILE RD
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48377-2009
Country	:	US
Telephone Number	:	248-668-8208
Fax Number	:

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

Provider Enumeration Date	:	06/19/2022
Last Update Date	:	06/19/2022

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Directions to “ MRS. NAGAMANI PALAKA ” Practice Location

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