Annamma Pullukat

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

4301043370 Issued in MI

Legal business name

ANNAMMA PULLUKAT

Practice address

44200 Woodward Ave Ste 103
Pontiac, MI 48341-5046

Phone

(248) 253-9600

Fax

(248) 253-0980

NPI assigned

Jun 25, 2018

Last updated

May 20, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly A Hodge

Title

Office Manager

Phone

(248) 253-9600

Specialties & licenses 1

Addresses

Tax ID family

Annamma Pullukat2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Annamma Pullukat

  • Pediatrics Physician
  • Pontiac, MI
  • NPI 1518552413
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Annamma Pullukat

  • Pediatrics Physician
  • Pontiac, MI
  • NPI 1518552413
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1932694767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE STE 103",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415046",
            "telephone_number": "248-253-9600",
            "fax_number": "248-253-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE STE 103",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415046",
            "telephone_number": "248-253-9600",
            "fax_number": "248-253-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNAMMA PULLUKAT",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-25",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-253-9600"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301043370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanti Anderson, LPC
• Cassidy Andrusz
• Anfair Medical Services PC
• Angels Unaware
• Annamma Pullukat
• Annointed Home Care Inc (Allied nursing care inc)
• Annointed Outreach
• Ruth Anthonio-Lindsey
• John Vito Antonucci, M.D.
• Dimitrios Apostolou, M.D.

• Pediatric Adolescent Medicine Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Pediatric Adolescent Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.