Organization
NARSIMHA GOTTAM M.D. P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NARSIMHA REDDY GOTTAM M.D. (OWNER)
(313) 499-4769
Entity
Organization
Contact information
Practice address
7633 E JEFFERSON AVE., SUITE #360, DETROIT, MI 48214-3732
(313) 499-4769
(313) 822-2791
Mailing address
P.O. BOX 7560, BLOOMFIELD HILLS, MI 48302-7560
(313) 499-4769
(313) 822-2791
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
1020303
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104504749
—
MI
Enumeration date
10/31/2007
Last updated
11/01/2012
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