Organization
CHAKRADHAR C REDDY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PREMLATHA C REDDY (MANAGER)
(586) 791-5210
Entity
Organization
Contact information
Practice address
36232 GARFIELD RD, CLINTON TWP, MI 48035-1128
(586) 791-5210
(586) 791-0049
Mailing address
36232 GARFIELD RD, CLINTON TWP, MI 48035-1128
(586) 791-5210
(586) 791-0049
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
034413
MI
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508909128
—
MI
01
—
4301034413
PHYSICIAN LICENSE
MI
Enumeration date
02/14/2007
Last updated
11/04/2021
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