Individual
BHARATHI DUKKIPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
24555 HAIG ST, TAYLOR, MI 48180
(313) 291-7800
Mailing address
HENRY FORD HEALTH SYSTEM, 15401 EAST JEFFERSON, GROSSE POINTE PARK, MI 48230
(313) 824-4800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301076475
MI
207RN0300X
Nephrology Physician
Primary
4301076475
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
489595510
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
BG076475
CHAMPUS-CHAMPUS
—
Enumeration date
05/19/2006
Last updated
05/29/2018
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