Provider Demographics
NPI:1124137203
Name:PALAKURTHI, LAKSHMI C (MD)
Entity type:Individual
Prefix:MRS
First Name:LAKSHMI
Middle Name:C
Last Name:PALAKURTHI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1777 AXTELL DR
Mailing Address - Street 2:#109
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4404
Mailing Address - Country:US
Mailing Address - Phone:248-649-2626
Mailing Address - Fax:248-649-5284
Practice Address - Street 1:1777 AXTELL DR
Practice Address - Street 2:#109
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4404
Practice Address - Country:US
Practice Address - Phone:248-649-2626
Practice Address - Fax:248-649-5284
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2014-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI207R00000X207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH22222Medicare UPIN