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General NPI Number Information
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NPI Number | 1124313861
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Entity Type | Organization
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Legal Business Name | RAJAMATHIAS Y REDDY MD, PLLC
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 901 KIMOLE LN STE B3
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City | ADRIAN
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State | MI
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Zip | 49221-1491
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Country | US
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Telephone | 517-263-7337
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Fax | 517-263-6150
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Provider Business Mailing Address
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Address Line | 901 KIMOLE LN STE B3
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City | ADRIAN
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State | MI
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Zip | 49221-1491
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Country | US
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Telephone | 517-263-7337
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Fax | 517-263-6150
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RAJAMATHIAS Y REDDY
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Credential | MD
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Telephone | 517-263-7337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | RR066814
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License Number State | MI
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