Individual
CHAKRADHAR COOCHCULA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36232 GARFIELD, CLINTON TWP, MI 48035
(586) 791-5210
(586) 791-0049
Mailing address
36232 GARFIELD, CLINTON TWP, MI 48035
(586) 791-5210
(586) 791-0049
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
4301034413
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235291667
—
MI
01
—
4301034413
PHYSICIAN LICENSE
MI
Enumeration date
12/14/2006
Last updated
11/04/2021
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