DR. SRINIVAS B MUKKAMALA (NPI# 1104876028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104876028 |
| Entity Type | Individual |
| Full Name | DR. SRINIVAS B MUKKAMALA |
| Credential | M.D. |
| Practice Address |
1170 Charter Dr Suite F Flint MI 48532 |
| Mailing Address |
1170 Charter Dr Suite F Flint MI 48532-3587 |
| Practice Telephone | 8102448400 |
| Practice Fax Number | 8102448410 |
| Mailing Telephone | 8102448400 |
| Mailing Fax Number | 8102448410 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2018-08-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | SM075543 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4203511 | 05 |
| Street Address |
1170 CHARTER DR SUITE F |
| City | FLINT |
| State | MI |
| Zip Code | 48532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407818594 | Damayanthi V Pandrangi | Internal Medicine | 1170 Charter Dr, Suite A, Flint, MI 48532-3587 | 2006-04-04 |
| 1982099503 | Muhammad Amin | Physical Therapist | 1170 Charter Dr, Suite C, Flint, MI 48532-3587 | 2015-03-31 |
| 1518120484 | Premasudha C Ramadas | Internal Medicine | 1170 Charter Dr, Suite A, Flint, MI 48532-3587 | 2008-07-09 |
| 1225205776 | Damayanthi Pandrangi Md PC | Internal Medicine | 1170 Charter Dr, Suite E, Flint, MI 48532-3587 | 2008-05-14 |
| 1891910949 | Christine E. Gower | Audiologist-Hearing Aid Fitter | 1170 Charter Dr, Suite F, Flint, MI 48532-3587 | 2007-04-16 |
| 1356414577 | Nita M. Kulkarni, M.d., P.l.c. | Specialist | 1170 Charter Dr, Suite F, Flint, MI 48532-3587 | 2006-11-16 |
| 1093888216 | Srinivas B. Mukkamala. M.d., P.l.c. | Specialist | 1170 Charter Dr, Suite F, Flint, MI 48532 | 2006-11-16 |
| 1033132188 | Geeta D Rode | Internal Medicine | 1170 Charter Dr, Ste D, Flint, MI 48532 | 2006-07-26 |
| 1164455895 | Jitendra P Katneni Md PC | Internal Medicine | 1170 Charter Dr, Suite A, Flint, MI 48532-3587 | 2006-07-08 |
| 1154370955 | Nita M Kulkarni | Obstetrics & Gynecology | 1170 Charter Dr, Suite F, Flint, MI 48532 | 2006-05-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1639709496 | Tammara Kamei | Counselor | 2425 S.linden Rd, Suite D Unit 100, Flint, MI 48532 | 2020-01-21 |
| 1306481882 | Christine Rice | Case Manager/Care Coordinator | 3169 Beecher Road, Flint, MI 48532 | 2019-11-08 |
| 1780154336 | Sarah Marie Shaw | Case Manager/Care Coordinator | 2091 Professional Drive, Flint, MI 48532 | 2018-11-27 |
| 1215412093 | Adria D Haynes | Social Worker | G-4413 Corunna Rd., Flint, MI 48532 | 2018-09-27 |
| 1689159378 | Vip Smiles Dentistry, Pllc | Dentist | 1104 South Linden Rd, Building B, Suite 1, Flint, MI 48532 | 2018-09-27 |
| 1942794797 | Premier Eye Specialists Pllc | Ophthalmology | 1160 S Linden Rd, Bldg. 1 Ste. A, Flint, MI 48532 | 2018-06-15 |
| 1720587710 | Cassandra Socia | Dental Hygienist | G3222 Beecher Road, Flint, MI 48532 | 2018-02-06 |
| 1235660291 | Ashley L Boltjes | Massage Therapist | 3277 Beecher Rd, Flint, MI 48532 | 2017-03-22 |
| 1497202774 | Tyneshia Mcfarland | Home Health | 2104 Ridgecliffe Dr, Flint, MI 48532 | 2016-09-05 |
| Find all providers in zip 48532 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437325644 | Nasir Ahmad Md PC | Otolaryngology | 1128 S Linden Rd Ste 10, Flint, MI 48532-3454 | 2008-05-07 |
| 1568574119 | Anthony A Pavone | Otolaryngology | 5051 Villa Linde Pkwy Ste 29, Flint, MI 48532-3449 | 2006-08-31 |
| 1528133188 | Nasir Ahmad | Otolaryngology | 1128 S Linden Rd, Suite 10, Flint, MI 48532-3410 | 2006-11-21 |
| 1972608693 | Anthony Pavone Do PC | Otolaryngology | 5051 Villa Linde Pkwy Ste 29, Flint, MI 48532-3449 | 2006-09-14 |
| 1972535201 | Leonard L J Dias Md PC | Otolaryngology | 5051 Villa Linde Pkwy, Suite #29, Flint, MI 48532-3449 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104445980 | Anuja Dharap | Otolaryngology | 35630 Grand River Ave Apt 217, Farmington Hills, MI 48335-3120 | 2020-04-13 |
| 1598311334 | Cogent Medical Group Pllc | Otolaryngology | 28300 Orchard Lake Rd Ste 101, Farmington Hills, MI 48334-3704 | 2019-08-16 |
| 1073025334 | Robert J Stachler Md PC | Otolaryngology | 33200 W. 14 Mile Rd., Ste. 240, West Bloomfield, MI 48322 | 2017-10-26 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1174905822 | Scott Jacob Schwartz | Otolaryngology | 6900 Orchard Lake Rd Ste 314, West Bloomfield, MI 48322-3457 | 2015-06-18 |
| 1669868402 | Cameron M Heilbronn | Otolaryngology | 21000 E 12 Mile Rd Ste 111, Saint Clair Shores, MI 48081-1156 | 2015-04-08 |
| 1104230523 | Gary Zachary White | Otolaryngology | 300 North Ave Ste 1400, Battle Creek, MI 49017 | 2014-06-13 |
| 1437574530 | Beacon Medical Group, Inc. | Otolaryngology | 711 S Health Pkwy Ste 1, Medical Office Building #1, Three Rivers, MI 49093-8354 | 2014-02-26 |
| 1124361621 | Eric Fahed Succar | Otolaryngology | 44200 Woodward Ave Ste 201, Pontiac, MI 48341-5045 | 2013-04-03 |
| 1396086286 | Nathan Vandjelovic | Otolaryngology | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2013-03-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.