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Individual
SAILAJA PEDDIREDDY
Active
Individual
SAILAJA PEDDIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
#4301075965
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
4301075965
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110F336360
BCBSM
MI
01
—
20-5485614
TAX ID
MI
01
—
SP075965
LICENS
MI
Enumeration date
01/29/2008
Last updated
12/13/2013
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