| NPI | 1003143835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REVANASIDDAPPA N MARAGIRI Doctor 989-415-0358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301055673) |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2009-11-16 |