Individual
DR. PRASAD J THOTTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7001 OCHARD LAKE ROAD, 320C, WEST BLOOMFIELD, MI 48322-3607
(248) 571-3600
(248) 973-8560
Mailing address
7001 OCHARD LAKE ROAD, SUITE 320C, WEST BLOOMFIELD, MI 48322-3607
(248) 571-3600
(248) 973-8560
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
5101018245
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383490114
TAX ID
MI
Enumeration date
11/05/2013
Last updated
04/10/2025
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