Provider Demographics
NPI:1902036981
Name:SYNERGY MEDICAL ALLIANCE
Entity Type:Organization
Organization Name:SYNERGY MEDICAL ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MITTADODLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-860-8279
Mailing Address - Street 1:114 SHERRFIELD DR
Mailing Address - Street 2:V9
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-6474
Mailing Address - Country:US
Mailing Address - Phone:989-860-8279
Mailing Address - Fax:
Practice Address - Street 1:114 SHERRFIELD DR
Practice Address - Street 2:V9
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6474
Practice Address - Country:US
Practice Address - Phone:989-860-8279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301094995282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital