Provider Demographics
NPI:1003213224
Name:KARTHA PLLC
Entity Type:Organization
Organization Name:KARTHA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLO PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARTHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-281-7040
Mailing Address - Street 1:15265 NORTHLINE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2487
Mailing Address - Country:US
Mailing Address - Phone:734-281-7040
Mailing Address - Fax:734-285-2005
Practice Address - Street 1:15265 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2487
Practice Address - Country:US
Practice Address - Phone:734-281-7040
Practice Address - Fax:734-285-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301055974261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty