Most Relevant Information
Provider Data
| NPI Number: | 1003050113 |
| Provider Name: | SURESH KUMAR KOMIRISETTY |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 5302034766 |
Most Important Dates
| Enumeration Date: | 04/21/2009 |
| Last Updated: | 04/21/2009 |
Provider Practice Location
1705 W MOUNT HOPE AVE
LANSING
MI
489102660
Practice Location Phone/Fax
| Phone: | 5173726700 |
| Fax: | 5173720616 |
Provider Mailing Location
1795 NEMOKE CT
APARTMENT # 9
HASLETT
MI
488408679
Provider Mailing Phone/Fax
| Phone: | 2705358708 |
| Fax: |