Individual
SHALINI THOUTREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1295 BARRY DR STE B, LAPEER, MI 48446-1369
(810) 667-4994
Mailing address
1295 BARRY DR STE B, LAPEER, MI 48446-1369
(810) 667-4994
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4301080565
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103307661
BLUE CROSS BLUE SHIELD OF MICHIGAN/BLUE CARE NETWORK
MI
01
—
200000026973
PHYSICIANS HEALTH PLAN
MI
01
—
7470740
AETNA
MI
Enumeration date
07/07/2005
Last updated
11/15/2023
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