Individual
RAJAMATHIAS Y REDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 KIMOLE LN, STE B3, ADRIAN, MI 49221-1491
(517) 263-7337
(517) 263-6150
Mailing address
901 KIMOLE LN, STE B3, ADRIAN, MI 49221-1491
(517) 263-7337
(517) 263-6150
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
RR066814
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03715
PARAMOUNT PROVIDER #
MI
01
—
114183
CARE CHOICES PROVIDER #
MI
01
—
3504600762
BCBS PROVIDER #
MI
05
—
4125980
—
MI
01
—
RR066814
LICENSE NUMBER
MI
Enumeration date
10/12/2006
Last updated
07/09/2007
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