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Individual

ESPRIN REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
N16088 BALSAM LN, SPALDING, MI 49886
(906) 497-5263
Mailing address
1A CAMBRIDGE DR, GLADSTONE, MI 49837-2469
(906) 497-5263

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301063991
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10062108
RAILROAD MEDICARE
01
32957900
WI MEDICAID GROUP
01
32958000
WI MEDICAID GROUP
WI
01
32958100
WI MEDICAID GROUP
WI
05
34500400
WI
01
382375778005
CHAMPUS GROUP
Enumeration date
01/11/2007
Last updated
04/16/2008
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