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Individual

SUDARSHAN R REDDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
43281 COMMONS, CLINTON TWP, MI 48038
(586) 263-6050
(586) 263-0436
Mailing address
43281 COMMONS, CLINTON TWP, MI 48038
(586) 263-6050
(586) 263-0436

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301039506
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
15726310
MI
05
1572763024
MI
01
2405003712
BCBS
MI
01
A73212
HAP
MI
Enumeration date
12/01/2005
Last updated
03/20/2015
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