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General NPI Number Information
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NPI Number | 1225599194
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Entity Type | Individual
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Provider Name | RADHIKA GUTTA DO
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Gender | Female
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 2800 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48202-2610
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Country | US
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Telephone | 888-777-4167
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Fax | 313-876-1305
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Provider Business Mailing Address
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Address Line | 6272 CANTER CREEK TRL
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City | GRAND BLANC
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State | MI
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Zip | 48439-7440
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Country | US
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Telephone | 810-869-9800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 510128586
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 510128586
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License Number State | MI
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