Provider Demographics
NPI:1396534707
Name:ALLA, SAI SANTHOSHA MRUDUL (MD)
Entity type:Individual
Prefix:MISS
First Name:SAI SANTHOSHA MRUDUL
Middle Name:
Last Name:ALLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44405 WOODWARD AVE TRINITY HEALTH OAKLAND
Mailing Address - Street 2:GRADUATE MEDICAL EDUCATION DEPT
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341
Mailing Address - Country:US
Mailing Address - Phone:248-858-6233
Mailing Address - Fax:248-858-3244
Practice Address - Street 1:44405 WOODWARD AVE TRINITY HEALTH OAKLAND
Practice Address - Street 2:GRADUATE MEDICAL EDUCATION DEPT
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-858-6233
Practice Address - Fax:248-858-3244
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program