Doctor Name: | DR. ANITHA KOMPALLY |
NPI Number: | 1396912705 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | |
Business Practice Address: | 16001 W 9 Mile Rd Southfield, MI - 480754818 |
Business Phone Number: | 7344640887 |
Business Fax Number: | 7344020254 |
Mailing Address: | 36115 Schoolcraft Rd, LIVONIA |
State: | MI |
Postal Code: | 481501216 |
Phone Number: | 7344640887 |
Fax Number: | 7344020254 |
NPI Enumeration Date: | 05/14/2008 |
NPI Last Update Date: | 08/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |