Provider Demographics
NPI:1053873539
Name:DEVINENI, SHRUTI KONDA (DO)
Entity type:Individual
Prefix:
First Name:SHRUTI
Middle Name:KONDA
Last Name:DEVINENI
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Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:LOBBY J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:IHA HOWELL PRIMARY CARE
Practice Address - Street 2:202 W HIGHLAND RD.
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843
Practice Address - Country:US
Practice Address - Phone:517-234-6540
Practice Address - Fax:517-338-9083
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2023-01-11
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Provider Licenses
StateLicense IDTaxonomies
MI5101026924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine