Individual
DR. SUBHASCHANDRA REDDY RAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 W MAIN ST, HARTFORD, MI 49057-1005
(269) 621-2166
(269) 621-2566
Mailing address
30 W MAIN ST, HARTFORD, MI 49057-1005
(269) 621-2166
(269) 621-2566
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301037460
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11286631
CAQH
MI
05
—
1790118
—
MI
01
—
3508062072
BCBS OF MICHIGAN
MI
Enumeration date
12/07/2006
Last updated
07/08/2007
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