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General NPI Number Information
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NPI Number | 1700160967
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Entity Type | Individual
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Provider Name | HARIHARAPRASAD RAO REDYSHETTY RPH
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Gender | Male
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 450 N PARK BLVD
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City | LAKE ORION
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State | MI
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Zip | 48362-3152
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Country | US
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Telephone | 248-814-7315
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Fax | 278-814-7364
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Provider Business Mailing Address
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Address Line | 2445 ANDOVER BLVD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48306-4937
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Country | US
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Telephone | 248-275-5635
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302036344
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License Number State | MI
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