Organization
B PRAVEEN REDDY M.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOBBILI PRAVEEN REDDY M.D. (PRESIDENT)
(248) 730-6438
Entity
Organization
Contact information
Practice address
440 W RUSSELL ST, SALINE, MI 48176-1184
(248) 730-6438
Mailing address
P.O. BOX 30, NORTHVILLE, MI 48168-0030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00603330
MEDICARE TRAV
MI
Enumeration date
09/01/2006
Last updated
02/10/2011
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