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General NPI Number Information
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NPI Number | 1639229719
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Entity Type | Individual
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Provider Name | ESPRIN REDDY M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | N16088 BALSAM LN
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City | SPALDING
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State | MI
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Zip | 49886
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Country | US
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Telephone | 906-497-5263
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Fax |
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Provider Business Mailing Address
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Address Line | 1A CAMBRIDGE DR
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City | GLADSTONE
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State | MI
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Zip | 49837-2469
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Country | US
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Telephone | 906-497-5263
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301063991
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License Number State | MI
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