MEDICARE: HEMATOLOGY AND ONCOLOGY CENTER, PC

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	207RH0003X	Hematology & Oncology Physician

General Provider Information

NPI Number	:	1922755792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEMATOLOGY AND ONCOLOGY CENTER, PC

Provider Business Mailing Address
First Line	:	18451 W 12 MILE RD STE 101
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-2635
Country	:	US
Telephone Number	:	947-224-9299
Fax Number	:

Provider Business Practice Location Address
First Line	:	18451 W 12 MILE RD STE 101
Second Line	:
City	:	LATHRUP VILLAGE
State	:	MI
Zip	:	48076-2635
Country	:	US
Telephone Number	:	947-224-9299
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. VATSALA KATRAGADDA
Credential	:	M.D.
Telephone Number	:	947-224-9299

Provider Enumeration Date	:	03/02/2022
Last Update Date	:	03/02/2022

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