NPI 1003050113

Suresh Kumar Komirisetty

Practitioner Pharmacist Lansing, MI

Practice location

Address: 1705 W Mount Hope Ave, Lansing, MI 48910-2660
Phone: (517) 372-6700
Fax: (517) 372-0616
Mailing address: 1795 Nemoke CT Apartment # 9, Haslett, MI 48840-8679

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 5302034766 (MI)

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Registry record

NPI: 1003050113
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Apr 2009
Record last updated: 21 Apr 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.