Individual provider · Type 1 NPI

Shivani V. Kondagunta, PA-C

Physician Assistant · Detroit, MI

NPI number 1306735311 Active

Practice location

259 Mack Ave
Detroit, MI 48201-2427

Call (313) 577-1716 Map

Mailing address

5300 Elliott Dr
Ypsilanti, MI 48197-8632

Other practice locations

  • 5300 Elliott Dr, Ypsilanti, MI 48197-8632 · (734) 434-6262

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X5601013554 (MI)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1306735311

Shivani V. Kondagunta, PA-C's National Provider Identifier is 1306735311, issued on Jul 2, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Detroit, MI. The record was last updated on Feb 27, 2026.