Provider Demographics
NPI:1659904043
Name:MALEMPATI, APARNA JAGARLAMUDI
Entity Type:Individual
Prefix:
First Name:APARNA
Middle Name:JAGARLAMUDI
Last Name:MALEMPATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2447 WESTBROOKE CIR S
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-3143
Mailing Address - Country:US
Mailing Address - Phone:586-212-6220
Mailing Address - Fax:
Practice Address - Street 1:22421 PONTIAC TRL
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-1642
Practice Address - Country:US
Practice Address - Phone:248-437-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist