Individual
DR. JAYA RAGHU TEJA TEJA GADIVEMULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 ST. ANTOINE, STE 2E, DETROIT, MI 48201
(313) 745-4525
Mailing address
4201 ST. ANTOINE, STE 2E, DETROIT, MI 48201
(313) 745-4525
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
321436
LA
Other
Enumeration date
06/22/2015
Last updated
12/30/2019
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