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Organization
PROFESSIONAL PRIMARY CARE SERVICES PC
Active
Organization
PROFESSIONAL PRIMARY CARE SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYAKAR REDDY KANMANTHA REDDY M.D. (PRESIDENT)
(248) 396-6667
Entity
Organization
Contact information
Practice address
43996 WOODWARD AVE STE 104, BLOOMFIELD HILLS, MI 48302-5028
(248) 977-4138
Mailing address
PO BOX 7752, BLOOMFIELD HILLS, MI 48302-7752
(248) 396-6667
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301068131
MI
Other
Enumeration date
10/11/2007
Last updated
07/11/2011
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