1700923281 NPI number — HEMALATA REDDY MD

Table of content: DR. TIMOTHY ADAMS JR. M.D. (NPI 1891749107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700923281 NPI number — HEMALATA REDDY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEMALATA REDDY MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700923281
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 548
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48012-0548
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-652-7520
Provider Business Mailing Address Fax Number:
248-652-7906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4727 SAINT ANTOINE ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48201-1461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-745-9098
Provider Business Practice Location Address Fax Number:
248-652-7906
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
REDDY
Authorized Official First Name:
HEMALATA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
313-745-9098

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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