Individual
SUDHAKER DHANWADA RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 3031 WEST GRAND BLVD., DETROIT, MI 48202
(313) 916-2454
Mailing address
HENRY FORD HEALTH SYSTEM, 3031 WEST GRAND BLVD. SUITE # 800, DETROIT, MI 48202
(313) 916-5822
(313) 916-8343
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
034261
MI
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
034261
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128194410
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
DR034261
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/01/2006
Last updated
01/29/2013
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