Dr. Simon J Pullukat, MD
Family Medicine in Pontiac, MI. Individual provider (NPI-1).
NPI number1881702322
StatusActive
Last updated in NPPESFeb 3, 2016
Details
- NPI
- 1881702322
- Entity type
- Individual (NPI-1)
- Name
- Dr. Simon J Pullukat
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 25, 2006
- Last updated
- Feb 3, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 4301035015 | MI | Yes |
Practice location
35 South Johnson Suite 2-DPontiac, MI 48341
Phone 268-338-0860 · Fax 268-338-6013
Mailing address
1075 N Edgar RdMason, MI 48854-9584
Phone 248-563-3848
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