Individual
SANTHI NIMMAGADDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19001 HUBBARD DR, DEARBORN, MI 48126-2637
(313) 441-1160
(313) 441-1870
Mailing address
19001 HUBBARD DR, DEARBORN, MI 48126-2637
(313) 441-1160
(313) 441-1870
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301076231
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000390002
ANTHEM BCBS
—
01
—
04783
PARAMOUNT
—
05
—
2621176
—
OH
Enumeration date
07/23/2006
Last updated
11/16/2007
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