Provider Demographics
NPI:1902303522
Name:SANNAPANENI, SHILPA KALA (MD)
Entity type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:KALA
Last Name:SANNAPANENI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHILPA
Other - Middle Name:KALA
Other - Last Name:SANNAPANENI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:21816 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-3724
Mailing Address - Country:US
Mailing Address - Phone:248-375-4040
Mailing Address - Fax:248-375-4044
Practice Address - Street 1:21816 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-3724
Practice Address - Country:US
Practice Address - Phone:248-375-4040
Practice Address - Fax:248-375-4044
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301508115207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine