Organization
NEPHROLOGY HYPERTENSION CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PINNAMANENI PRASAD MD (PRESIDENT)
(313) 271-3000
Entity
Organization
Contact information
Practice address
16407 SOUTHFIELD RD STE A, ALLEN PARK, MI 48101-2571
(313) 271-3000
(313) 271-3003
Mailing address
16407 SOUTHFIELD RD STE A, ALLEN PARK, MI 48101-2571
(313) 271-3000
(313) 271-3003
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0Q26434
BCBSM
—
Enumeration date
01/23/2007
Last updated
08/22/2023
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