Provider Demographics
NPI:1811275209
Name:BAJJURI, SRIRANJANI (MD)
Entity type:Individual
Prefix:
First Name:SRIRANJANI
Middle Name:
Last Name:BAJJURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SRIRANJANI
Other - Middle Name:
Other - Last Name:TUMULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 HURLEY PLZ
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5902
Mailing Address - Country:US
Mailing Address - Phone:810-262-9000
Mailing Address - Fax:
Practice Address - Street 1:400 W ARBROOK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3175
Practice Address - Country:US
Practice Address - Phone:817-276-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098059207R00000X, 208000000X
TXV0685207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics