Organization
RENAL CONSULTANT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAMPALA H REDDY MD (PRESIDENT)
(248) 817-5264
Entity
Organization
Contact information
Practice address
1380 COOLIDGE HWY STE 150, TROY, MI 48084-7058
(248) 817-5264
(248) 829-7752
Mailing address
PO BOX 251221, WEST BLOOMFIELD, MI 48325-1221
(248) 720-9226
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
GR088423
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F39037
BCBS
MI
Enumeration date
07/14/2010
Last updated
12/27/2023
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