Provider Demographics
NPI:1346809464
Name:BAPATLA, ANUSHA (MD)
Entity Type:Individual
Prefix:
First Name:ANUSHA
Middle Name:
Last Name:BAPATLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MAIN, 6071 WEST OUTER DRIVE
Mailing Address - Street 2:SINAI-GRACE HOSPITAL, DEPARTMENT OF INTERNAL MEDICINE
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-989-9250
Mailing Address - Fax:
Practice Address - Street 1:4 MAIN, 6071 WEST OUTER DRIVE
Practice Address - Street 2:SINAI-GRACE HOSPITAL, DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-989-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program