Provider Demographics
NPI:1295389294
Name:DUPATI GROUP PLLC
Entity Type:Organization
Organization Name:DUPATI GROUP PLLC
Other - Org Name:APOLLO DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARJUN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-802-1310
Mailing Address - Street 1:555 BARCLAY CIR STE 170
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4574
Mailing Address - Country:US
Mailing Address - Phone:415-802-1310
Mailing Address - Fax:
Practice Address - Street 1:555 BARCLAY CIR STE 170
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4574
Practice Address - Country:US
Practice Address - Phone:415-802-1310
Practice Address - Fax:248-294-1388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty