Individual
SADASIVA T REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 N EAST AVE, IMAGING DEPARTMENT, JACKSON, MI 49201-1753
(517) 783-2612
(517) 783-5991
Mailing address
2800 SPRING ARBOR RD STE 102, PO BOX 905, JACKSON, MI 49203-3895
(517) 783-2612
(517) 783-5991
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301037206
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1329251
—
MI
01
—
300020173
RAILROAD MEDICARE
—
01
—
3003853751
BCBS OF MICHIGAN
MI
01
—
4301037206
STATE OF MICHIGAN MEDICAL LICENSE
MI
Enumeration date
08/10/2005
Last updated
11/09/2015
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