Provider Demographics
NPI:1811179054
Name:PALANICHAMY, NANTHINI D (MD, FACC)
Entity type:Individual
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First Name:NANTHINI
Middle Name:D
Last Name:PALANICHAMY
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Gender:F
Credentials:MD, FACC
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Mailing Address - Street 1:44555 WODWARD AVENUE
Mailing Address - Street 2:STE #403
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341
Mailing Address - Country:US
Mailing Address - Phone:248-338-2420
Mailing Address - Fax:248-858-3888
Practice Address - Street 1:44555 WOODWARD AVENUE
Practice Address - Street 2:SUITE #403
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-338-2420
Practice Address - Fax:248-858-3888
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2017-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAMD.201543207RC0000X
MI4301080736207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease