Individual
LINGAREDDY DEVIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11900 E 12 MILE RD, SUITE 103, WARREN, MI 48093-3487
(586) 574-0890
(586) 574-9321
Mailing address
11900 E 12 MILE RD, SUITE 103, WARREN, MI 48093-3487
(586) 574-0890
(586) 574-9321
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301032513
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301032513
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000002170A
CAPE
—
01
—
0383495817
DCM
—
01
—
038349581701
SMART
—
01
—
0600039840M95180
PALMETTO
—
01
—
100566
GREAT LAKES
—
05
—
108252010
—
MI
01
—
109256
PREFERRED CHOICES
—
01
—
110E014810
BCBS
—
01
—
1110800008
WELLNESS
—
01
—
321304
ULTIMED
—
01
—
52410
OMNI
—
01
—
A74279
HAP
—
01
—
A8783
MCARE
—
Enumeration date
06/20/2006
Last updated
09/24/2019
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