Individual
DR. SRINIVAS REDDY MUMMADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
2122 HEALTH DR SW, WYOMING, MI 49519-9698
(616) 252-5220
(616) 252-5770
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
(616) 252-0260
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP1-0022250
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD 155301
OR
207RP1001X
Pulmonary Disease Physician
57.014364
OH
207RP1001X
Pulmonary Disease Physician
Primary
MD 155301
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2777707366
MYUTMB 2777707366-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
03/17/2018
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