Individual
JAYAKAR REDDY KANMANTHA REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 NORTH OAKLAND BOULEVARD, SUITE 175, WATERFORD TOWNSHIP, MI 48327
(248) 666-2756
(248) 666-2646
Mailing address
PO BOX 7752, BLOOMFIELD HILLS, MI 48302-7752
(248) 666-2756
(248) 666-2646
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301068131
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301068131
MI
Other
Enumeration date
08/03/2006
Last updated
09/11/2025
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