Organization
NEPHROLOGY HYPERTENSION CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDHEER UMMADI M.D. (MANAGER)
(313) 271-3000
Entity
Organization
Contact information
Practice address
16407 SOUTHFIELD RD, ALLEN PARK, MI 48101
(313) 271-3000
(313) 271-3003
Mailing address
PO BOX 77000 DEPT 771255, DETROIT, MI 48277-2000
(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
—
110Q264340
BCBSM
—
Enumeration date
11/21/2006
Last updated
01/30/2019
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