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Contact Information

SRINIVASA R KODALI
17940 FARMINGTON ROAD
SUITE 230
LIVONIA, MI48152-3194
 Phone: 734-422-4748
 Fax: 734-422-5076
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for SRINIVASA R KODALI · (Male)

NPI # 1255372058
Status Active
Credentials
Entity Individual
Enumeration date 06/10/2006
Last updated 11/04/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • MI License # 4301049890
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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