Organization
DETROIT MEDICAL CENTER
Active
Other names
Tenet Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
SREEDHAR REDDY MITTA MD (RESIDENT)
(865) 771-5715
Entity
Organization
Contact information
Practice address
3901 BEAUBIEN ST, DETROIT, MI 48201-2119
(313) 745-5147
Mailing address
678 SELDEN ST, DETROIT, MI 48201-2200
(865) 771-5715
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4351045516
MEDICAL LICENSE NUMBER
MI
Enumeration date
07/11/2019
Last updated
07/11/2019
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